Prevention

Prevention Division:

The HIV epidemic in the State of Punjab is concentrated in nature characterized by low prevalence in the general population and a high prevalence among High Risk Group (HRG) population. It is estimated that more than 90% of HIV transmission is related to unprotected sexual intercourse or sharing of injecting equipment between an infected and an uninfected individual. Not everyone in the population has the same risk of acquiring or transmitting HIV. Much of the HIV transmission occurs within groups or networks of individuals who have higher levels of risk due to a higher number of sexual partners or the sharing of injection drug equipment. Individuals who are most at risk include:

• Female sex workers (FSWs)
• High risk men who have sex with men (MSM), and Transgender (TGs)
• Injecting drug users (IDUs)

As per HIV Sentinel Surveillance report (HSS 2021), in Punjab, HIV prevalence among FSWs is 3.38%, among MSMs 11.62%, among IDUs 19.57% and among prison inmates 7.49%.

Given the pattern of epidemic transmission, it is most effective and efficient to target prevention towards HRG members to keep their HIV prevalence as low as possible, and to reduce transmission from them to the bridge population.

Prevention is the mainstay of the national strategy to control HIV/AIDS. Prevention intervention in the context of key population includes Targeted Intervention, Link Worker Scheme, Opioid Substitution Treatment and Intervention among Prisons & Other Closed Settings. 

Targeted Interventions (TIs) are prevention interventions that specifically address HRGs who are at risk of acquiring or transmitting HIV infection. The central purpose of TIs is to prevent transmission of HIV among HRGs and their sexual partners.

Intervention package for HRGs under TIs:

1. Outreach and Communication

• Interpersonal behaviour change communication which includes information on HIV/AIDS, STIs, safer sexual practices, safer injecting practices, general health & hygiene, linkage with the health services i.e. ICTC, STI, DOTS, ART etc.

1. Services

• Promotion/distribution of free condoms and other commodities (i.e. Lubricants for MSM)
• Harm reduction service (i.e. provision of Needles/Syringes under Needle/Syringe Exchange Programme (NSEP) , Abscess management and Oral Substitution Therapy (OST) for IDUs
• Prevention and Management of STI/RTI
• Linkage to other health services i.e. ICTC for HIV testing, ART for treatment, DOTS for TB treatment, Drug De-addiction and rehabilitation, Hep C Treatment etc.
• Provision of safe spaces (drop-in centres)

1. Creating an Enabling Environment

• Advocacy with key stakeholders
• Crisis management system
• Legal/rights education

Similarly, in order to address the risk and vulnerability of HRGs in rural pockets, Link Worker Scheme is being implemented in districts having high HIV positivity among rural population.

At present, following prevention interventions are being implemented in the State of Punjab