The overall prevalence of HIV/AIDS among antenatal women has dropped from 0.27% to 0.18% in Tamil Nadu, but eleven districts have recorded a higher prevalence than the State’s average. With Tamil Nadu having “sufficient” health infrastructure for testing and treatment, officials say they are looking to intensify measures to raise awareness for reducing HIV/AIDS prevalence in the districts.
According to the recently released 16th round of HIV Sentinel Surveillance (HSS), 2019, among pregnant women, the top five districts with high HIV prevalence are: Vellore (0.75%), Namakkal (0.75%), Krishnagiri (0.50%), Sivaganga (0.38%) and Coimbatore (0.38%). Tiruppur, Pudukottai, Madurai, Karur and Erode had a prevalence of 0.25% each. They were the other major districts with HIV prevalence higher than the State average.
Tirunelveli recorded an HIV prevalence of 0.17%, while Virudhunagar, Villupuram, Tiruvannamalai, Tiruchi, Tiruvallur, Salem, Kancheepuram and Cuddalore recorded 0.13%. The remaining 12 districts had zero HIV prevalence among antenatal care (ANC) clinic attendees.
HIV prevalence among ANC clinic attendees showed a declining trend at the State level and in most districts, including Chennai. A rising trend in the recent past was noted in Vellore and Namakkal. The findings from the round corroborated with previous rounds, showing a low and declining trend at the State level. A sustained declining trend among antenatal women, nationally and at the State level, is a positive indicator of the successful response of the National AIDS Control Programme. However, the district-level fluctuating trends are a continuing challenge, according to HSS.
What led to the drop in HIV prevalence among antenatal women? Deepak Jacob, project director of the Tamil Nadu State AIDS Control Society, said, “Antenatal women are mandatorily tested for HIV/AIDS. We are testing 12.5 lakh women a year at the level of primary health centres, taluk hospitals and government medical college hospitals. This is 130% of our target. We link those who test positive to the Anti-Retroviral Therapy centres, numbering 55.”
Through the campaign for prevention of mother-to-child transmission of HIV, prophylactic treatment is provided and the newborn of an HIV-positive mother is put on a drug regimen. At the end of three months, the baby is screened for HIV/AIDS, he added.
“The State has a robust testing network through Integrated Counselling and Testing Centres (ICTC). We have 807 standalone ICTCs and 2,200 facility ICTCs. If a person tests positive for HIV at a facility ICTC, he/she is referred to a standalone centre. Similarly, we have inked memoranda of understanding with 177 private medical facilities where testing is being conducted,” he said.
There are 16 mobile ICTCs, and there are plans to increase this to 27. A proposal for the same has been sent to the National AIDS Control Organisation. “These units will be deployed at the 27 district AIDS prevention and control units that monitor testing and linkages of ‘People Living with HIV/AIDS to ART centres’. These units function in districts with a high prevalence of HIV/AIDS,” he said.
He said that they were planning to intensify IEC campaigns in the 11 districts with higher HIV prevalence, since the State already had sufficient health infrastructure. Amid the pandemic, these efforts are likely to be re-activated during December or January.
Officials said some of the 11 districts were border districts, where migrant/floating population was one of the challenges. Vellore has a migrant/floating population, while the Krishnagiri-Namakkal belt has a trucker population. It was difficult to keep track of the migrant population, they said.
The project director recalled that TANSACS had taken up a special campaign last year, during which a counsellor and lab technician visited the houses of mothers who did not come to the hospitals, with their newborns, for testing.