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India – Factfile


Overview

India is a federal constitutional republic governed under a parliamentary system consisting of 28 states and 7 union territories. India is a pluralistic, multilingual, and multiethnic society. It is the seventh largest country in the world. India’s population is more than one billion making it the second most populous country after China.

In 2009, an estimated 2.4 million people (aged 15-49) were living with HIV, slightly lower than the 2.5 million reported in 2001. However, India remains just behind South Africa and Nigeria in numbers of persons living with HIV.  Women accounted for 38% of people living with HIV while children accounted for 4.4%.

With a concentrated HIV epidemic, India’s HIV prevalence continues to be high among key affected populations (6 to 8 times that of the general population). High HIV prevalence among female sex workers is observed in the South and rising trend is evident in the North East .Higher HIV prevalence among injecting drug users (IDUs) is also found in North Eastern States. However, it is localized in nature, and both rising and declining trends are observed in different North Eastern States thus indicating the dual nature of the epidemic. In 2006, new sites of high HIV prevalence among IDUs were identified in the states of Punjab, Tamil Nadu, West Bengal, Kerala and Maharashtra.  HIV prevalence among MSM is highest in the states of Karnataka, Andhra Pradesh, Manipur, Maharashtra, Delhi, Gujarat, Goa, Orissa, Tamil Nadu and West Bengal.

Nationally, HIV prevalence is notably higher among IDUs and men who have sex with men than among female sex workers and other population groups.  Still, sex work continues to act as the most important source of HIV infections due to the large number of clients becoming infected by sex workers.

Vulnerability and risk factors that could contribute to spread of the epidemic in India include gender discrimination, stigma and discrimination, and inadequate human resource and technical support that lead to slow progress in the scale-up of prevention, care and support programmes. Furthermore, there is a need to strengthen capacity and systems to effectively implement certain HIV programmes such as a strategic information management system, cohort tracking of ART, and ensuring quality data on children affected or infected by HIV as well as operational and functional governance structures.

 

Sources:
[1] UNAIDS, Report on the Global AIDS Epidemic, 2010.
[2] India, UNGASS Country Progress Report, 2010

[3] India, Ministry of Health and Family Welfare, NACO, Department of AIDS Control, Annual Report, 2009-10
[4] HIV Sentinel Surveillance, Country Report, NACO 2006 cited by National AIDS Control Organisation, Ministry of Health and Family Welfare, Government of India, New Delhi,  in UNGASS Country Report 2008, India

Momentum for Integration Project

Initiatives by FPAI under Building Momentum for SRH HIV Integration project supported by EU:

Objectives of the Project: To advocate for SRH – HIV integration in the operations of the CCM (Country Coordinating Mechanisms) of the Global Fund, country health system and to mobilize private sectors to  support integrated approach in India.

  • Technical Hub: Six consultants have been hired through a proper competitive process and provided training on SRH HIV integration, gender mainstreaming, Proposal development and Global Fund financial management as per their area of expertise. These consultants extended their support in conducting capacity building training with the civil society partner selected from different parts in India.
  • A Country team is  formed which includes representatives from – (a) the Ministry of Health and Family Welfare, (b) National AIDS Control Organization, (c) Country Coordinating Mechanism Members and CSOs working SRH and HIV, (d) representative of key populations, (e) National Youth Coalition and (f) youth representatives. It’s a multi stakeholder group which provides technical guidance to MA in taking forward the agenda of integration in India.
  • Issue brief on SRH – HIV Integration has been developed by the technical hub consultants with recommendations/messages for: (i) Policy makers and National Program Managers; (ii) SRH and/or HIV Service Providers; and (iii) Community Groups and Networks of People Living with HIV.
  • Capacity Building programs: Five workshops on (i) Sexual and Reproductive Health (SRH) and HIV Integration; (ii) Gender Equality and Mainstreaming; (iii) Project Proposal Development and (iv) Project Budgeting and Financial Management have been conducted. Almost 30 CSOs have been reached in an effort of promoting integration.
  • CSOs particularly working with key population like MSM, sex worker and drug users have been sensitized on the benefits and needs of integration of SRH and HIV.
  • Four regional youth coalition meetings for youth volunteers, youth coalition/ network and civil society organizations working with youth population across the country (Northern Region (Delhi, Punjab, Uttar Pradesh); Eastern Region (West Bengal & Jharkhand); Western Region (Madhya Pradesh (MP), Rajasthan, Gujarat) and Southern Region (Karnataka, Andhra Pradesh and Tamil Nadu) have been organized to sensitize and build a momentum for integration of SRH and HIV at civil society level.

Achievements:

  • The learning from the capacity building workshops has shown positive outcomes. During the follow up workshops held in 2013, one of the networks has been able to integrate family planning counselling at the Integrated Counselling and Testing Centre (ICTC) and incorporate screening of cancer cervix for antenatal mothers and PLHIV women who access PPTCT/ICTC services.
  • One of the CSOs working in the district of Bihar has integrated HIV counselling services in their SRH health centres and has been motivating the pregnant women and their partners for HIV testing.
  • Some of the CSOs are considering to revise their policies and guidelines to make their approach more integrated and comprehensive to SRH and HIV.
  • Small Grant Facility: Three CSOs (Dindigul District HIV Positive Society of Tamilnadu, Samarthan of Madhya Pradesh and Universal Service Organization of Odisha) have been provided small grant support. They have undertaken initiatives promoting and advocating for SRH – HIV integration at service delivery level.
  • Participants who had attended work shops have disseminated their learning in their respective organizations and some of them have submitted project integrated project proposals at the local level.
  • The project has received widespread media attention, with articles featuring in local as well as national newspapers. See a few examples below (click on image):     

Key Publications and Resources

What works? Sexual and reproductive health and HIV linkages for MSM and transgender people in India.
Year 2012 | Authors IPPF, UNFPA, MSMGF, UNAIDS
This “What works?” brief is designed to help programme managers, advocates and policy makers from governmental and non-governmental organizations to more effectively link SRH and HIV services for MSM and transgender people at the policy, systems, and service delivery levels.
(Download PDF)

Rapid assessment of sexual and reproductive health and HIV linkages: India.
Year 2012 | Authors: IPPF, UNAIDS, WHO, UNFPA, FPA India
This summary highlights the experiences, results and actions from the implementation of the Rapid Assessment Tool for Sexual and Reproductive Health and HIV Linkages in India.
(Download PDF)

Media coverage of the Momentum for Integration project in local and national newspapers.
Working with the media has been a key strategy in the implementation of the project in India. See examples of the articles featuring  the project.
Year 2012-13
(Download image)

Reduction in stigma and discrimination using SRH and HIV integration – A case study from Dindigul district in Tamil Nadu, India 
This case study details the impact of the Momentum for Integration project in Tamil Nadu and details the impact of media involvement.
Year 2013 | Authors: IPPF SARO, FPA India
(Download PDF) 

Contact

Ms. Mamta Srivastava
Advocacy Coordinator-SRH HIV Integration Project
Family Planning Association of India (FPAI)
SRHHIVADVOCACY@fpaindia.org

Susmita Choudhury
Project Coordinator SRH HIV Integration
schoudhury@ippfsar.org

Remote Himalayan region in Chamba district Himachal Pradesh India

Country List