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Vihaan, a support project for people living with HIV
Vihaan, a support project for people living with HIV (PLHIV) has currently, 225 Care & Support Centres (CSCs) running in 31 states and territories. Ten State Level Networks (SLNs) and 168 District Level Networks (DLNs) for PLHIV are partners, an unprecedented level of active participation by India’s PLHIV community organisations in a national programme. In addition, 61 helpdesks (run by DLNs) and 6 Children’s CSCs are also being implemented under the Vihaan programme.

Operational Guidelines for CSCs have been finalized under the Department of AIDS Control’s guidance, along with programme monitoring tools and reporting formats. The partner teams at state and district level have been oriented on the guidelines and trained to use the tools and formats.

In order to ensure smooth coordination with key stakeholders, Vihaan has established 27 State Oversight Committees (SOCs) chaired by SACS Project Directors of the respective State AIDS Control Societies. In SOC meetings, SACS officers review the performance of CSCs and address issues related to ART-CSC coordination. Community Advisory Boards have been formed to guide state and regional partners and will be involved in planning, implementation and review of the programme.  

At the end of 2013, 115,401 PLHIV (Pre-ART: 33,563; On-ART: 81,839) have been registered in the CSCs and provided with services such as counselling, referral and linkages to social benefit schemes, entitlements and other health care services. A key objective of the CSC is early linkage to ART Centres and retention of PLHIV in treatment.

Tracking loss-to-follow-up (LFU) cases of PLHIV who have dropped out of ART programme is a core activity of CSC teams. CSCs participated in ‘intensive LFU tracking drive’ initiated by the Department of AIDS Control (DAC) toward the end of last year, and 5,685 LFU cases have been linked back to ART centres.

Outreach by CSCs has already had an impact on the lives of PLHIV. In a district of Madhya Pradesh, a client who was registered with ART Centre in June 2011 discontinued treatment in early 2013. The Vihaan CSC received the details of this client in October 2013 and as part of follow-up, they visited the client’s home. Family members informed Vihaan team that the client was dead. As they left, the CSC team talked to some neighbours who informed them that the client was alive and kept in a dark room inside the home. 

The CSC team returned and after a great deal of persuasion, the family agreed to shift him to hospital. His lungs were filled with fluid, and he was immediately admitted to hospital. He has recovered and has started ART again. The CSC team also counselled family members, and their care has significantly improved.

At district level, CSCs are working in synergy with ART centres. Coordination meetings have been streamlined, along with data sharing between ART centre and CSC. In addition, CSCs are regularly participating in DAPCU review meetings at district level and soliciting support and coordination from other key players in the district. CSCs are also working closely with TI partners to ensure coverage of PLHIV from high-risk groups.

To ensure that instances of violence, stigma and discrimination are addressed, Discrimination Response Team (DRTs) have been formed in each CSC and are already successfully addressing cases at district level. In an example from Maharashtra, a family of three living with HIV were targets of abuse and violence, and the police refused action. 

Fortunately a relative reached out to the local CSC, and as a result of the DRT’s advocacy, the family is now assured appropriate security. The local newspaper carried this story with the family’s consent, and it has been inspirational to PLHIV in the locality.

A joint review meeting of Vihaan state and regional partners was organised in New Delhi in December in coordination with DAC. Vihaan were honoured to welcome the participation of Shri Lov Verma, IAS (Secretary of DAC), Dr. Rathore (DDG CST), Dr. Rewari (NPO ART), and the entire team from CST division DAC. 

Their remarks were of great encouragement, and their constructive inputs have helped Vihaan partners focus and improve the functioning of the CSCs. As this common platform was quite fruitful, Vihaan will organize regional review meetings to further enhance participation of SACS representatives.

Vihaan strive hard every day to ensure quality care and support services are available to PLHIV in the country. With support from DAC, the SACS and a range of other stakeholders, they are progressing fast. They would continue sharing the progress on regular basis from time to time.

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