Chapter 3

HIV/AIDS AWARENESS CAMPAIGN IN GUJARAT

The World Health Organization (WHO) started the development of the Global Strategy
for the prevention and control of AIDS in late 1985 seeing the impact of HIV infection
and AIDS was founded. This strategy was reviewed and discussed widely in 1986 and
served as the basis for initial action of the WHO against AIDS. The Global AIDS
Strategy has three objectives: a. to prevent HIV infection, b. to reduce the personal and
social impact of HIV infection and c. to unify national and international efforts against
AIDS (Rao D., 2000, pp.207-208). The Indian response to the risks of HIV/AIDS is
based on the global strategy proposed by the WHO.

HIV/AIDS is one of the major health issues in India. It has made an impact on the quality
of life and social status of the persons. The first AIDS cases were reported in India in the
mid-1980s (Pais, 1996). Since then, HIV infection appears to have spread rapidly in
several regions (NACO, 2001). In India, the first case of HIV was reported in 1986 in
Tamil Nadu. In the 1990s, rates of infection continued to increase, and responses were
strengthened. In the year of 1992, the government set up the NACO to control the spread
of HIV/AIDS in the country. In the same year, the government launched a Strategic Plan,
the National AIDS Control Program (NACP) for HIV prevention. This plan established
administration and technical program management as well as State AIDS Control
Societies (SACS) in twenty five states and seven union territories. State AIDS Control
Societies made a number of important improvements regarding HIV prevention,
particularly in blood safety (NACO 2007). Indeed, since the early 1990s, prevention and
education have become the key components of HIV/ AIDS control in India (NACO
2010, Ramasubban 1998).

After the discovery of the first HIV infection in 1986, the Government of India started
programmes for prevention and raising awareness under the Medium Term Plans; the
first plan (NACP-1, 1992-99) and the second plan (NACP-2, 1999-2006). In phase-1
focus was only towards blood safety. The main goal of Blood Safety Programme was to
make safe and adequate blood available in all parts of Gujarat State. Perhaps the Blood
safety programme was not enough for prevention and control of HIV/AIDS. The

51
National AIDS Control Programme (NACP) phase-2 aimed to reduce the spread of HIV
infection in India through behaviour change and at the same time increase the ability to
respond to the infection. However, with the growing complexity of the epidemic, there
have been changes in policy frameworks and approaches of the NACP. Here the focus
has shifted from raising awareness to the behaviour change, from a national response to a
decentralized response and an increasing engagement of NGOs and networks of people
living with HIV/AIDS.

On the basis of Phase 1 and 2 experiences, India developed the Third National AIDS
Programme (2007-2012). The primary goal of NACP-3 was to halt and reverse the
epidemic in India over the next 5 years by integrating programmes for prevention, care,
support and treatment. NACP-3 aims to achieve above mentioned goals through four-
pronged strategy: 1. Prevention of new infections in high risk groups and general
population through: Saturation of coverage of high risk groups with Targeted
Interventions (TIs), and Scaled up interventions in the general population, 2. Providing
greater care, support and treatment to a larger number of people living with HIV/AIDS,
3. Strengthening the infrastructure, systems and human resources in prevention, care,
support and treatment programmes at the district, state and national levels, and
[Link] a nation-wide Strategic Information Management System.

An emphasis on high risk groups give the impression that people outside the high risk
groups do not to get worry about HIV. Thus, the vulnerability of individuals outside the
HRGs (high risk groups) often remains unexamined (Craddock et al. 2004). For
prevention and control of HIV/AIDS, all the people of society should aware of this
epidemic is very necessary.

Those people who normally considered themselves of low risk often live with a false
notion of security, thinking that HIV could never infect them. Thus, they often go
untested and are often unknowingly exposed to the virus. To corroborate, studies (e.g.,
IIPS and ORC Macro 2008) have found that members of low risk groups have a very low
HIV/AIDS awareness rate. Furthermore, because of their lack of knowledge about modes
of transmission and preventive measures, once any member of a low risk group is
infected, the virus spreads rapidly among the general population. Therefore, increased
awareness about HIV transmission and prevention should help control spread of the virus
in the uninfected population (Vandemoortele and Delamonica 2002). This means to

52
reduce the danger of HIV diffusion in the general population, prevention measures also
need to target population groups with a low risk of HIV infection (Craddock et al. 2004).

HIV/AIDS prevention and education is difficult in India because Indians speak more than
400 languages. That means some HIV/AIDS prevention and education can be done at the
national level and many efforts are best carried out at the state levels and local levels.
Vast size of India makes it difficult to evaluate how well HIV/AIDS prevention is
working in the country as a whole. Most Indian states have a higher population than most
African countries, so a more detailed picture of the crisis can be gained by looking at
each state individually. Each state of India has its own AIDS Prevention and Control
Society, which carries out local initiatives with guidance from NACO. In the second
stage of the government’s National AIDS Control Program (NACP-2), which ended in
March 2006, states AIDS control societies received funding for youth campaigns, blood
safety checks, and HIV testing, among other things. Concurrently, various public
platforms raised awareness of the epidemic: concerts, radio dramas, a voluntary blood
donation day, and TV spots with a popular Indian film-star. Schools undertook HIV
education for young people. Teachers and peer educators were trained to teach about
AIDS, and students were educated through active learning sessions, including debates
and roleplaying (NACO 2009).

The Prevention and control of HIV in the State, State AIDS Cell (SAC) was created in
December-1992 for implementation of phase-1 of National AIDS Control Programme.
The implementation of the program was done by the State AIDS Cell in accordance with
the guidelines of NACO and the approval of the State Empowered Committee constituted
for the purpose at the State level. With a view to ensure speedy and effective
implementation of the programme through inter-sectoral coordination for AIDS
prevention, and also to involve NGOs, the State AIDS Empowered Committee decided to
convert the existing State AIDS Cell into a registered society. The Government of India
had also advised to constitute State AIDS Control Society for effective implementation
of the programme, especially the second phase beginning from April 1999. Since then
National AIDS Control Programme is being implemented through State AIDS Control
Society.

It is clear that till now, there is no curative method for this disease. Prevention of HIV
infection is one of the important strategies to reduce the burden of this health problem.
Education is considered as one of the essential methods to prevent this epidemic. People
53
should have better access to AIDS information, knowledge about transmission of AIDS,
STD (Sexual Transmitted Disease) treatment and impact of this disease, to stem the
growth of this disease. Sometimes, people living with HIV are abused by the community,
health workers, friends and even relatives. This often leads to personal suffering,
reducing the likelihood of treatment seeking behaviour and proper care. Evaluation of
knowledge, attitude and behaviour towards HIV/AIDS will give us greater insight into
the existing awareness of the individuals. It will be very helpful for health providers,
researchers and planners to make appropriate intervention to control the spread of
disease. Moreover, the evaluation would help in designing health programmes, suited to
the lifestyle needs of various communities. It will enhance the health condition of people
and act as a catalyst for the overall development of the country (James, 2010).

The NACO has prescribed guidelines on informed consent, confidentiality and testing. It
states: “HIV testing is more than a biological test, for it involves ethical, human, and
legal dimensions.” However, in practice NACO does not have the structure to ensure
such guidelines. There is a need for proper monitoring and providing legal framework to
address the breakdown of laws and codes. Until and unless such mechanism are created
through which one can put checks on inappropriate behaviour of NGOs and health
professionals, putting this philosophy to practice would remain a difficult proposition.
The confidentiality in the case of HIV/AIDS is crucial for the HIV patients because
intensity of stigmatisation of the infected persons (Sharma, 2010).

There are many programmes conducted by the Gujarat State Government for prevention
and control of HIV/AIDS in Gujarat. These programmes strictly followed the guidelines
of NACO. Such programmes includes: 1. ICTC , [Link] Intervention (TI), [Link]
Care Services, [Link] Safety Programme, [Link], Education & Communication,
[Link] Ribbon Club Programme, [Link] Education and Lifeskill Programme (HELP), 8.
Link Worker Scheme (LWS), 9. Care, Support and Treatment, ART Centre and LAC,
[Link] Care Centres (CCC) etc. and [Link] Information Management Unit
(SIMU).

3.1 Strategies of GSACS in Gujarat

We cannot get a detailed picture about HIV/AIDS without the knowledge of medical and
biological sciences. From the time when the world aware about the epidemic, the people
living with HIV/AIDS have been faced social reaction like fear, discrimination and
54
shame from unaware people. Social stigma and discrimination have attached with the
HIV/AIDS. So the people living with HIV/AIDS have been suffering social boycott from
family, beloved persons and society.

The “State AIDS Cell” has been started in 1992 by the government of Gujarat for the
prevention and control of the epidemic. Rapid industrialization and urbanization are the
peculiar characteristics of the state. It leads to migration, which increased the infection of
HIV/AIDS in community. The first case of the HIV/AIDS identified in the Gujarat state
in 1986. The GSACS by the Health and Family Welfare Department (HFWD)of the
Gujarat state have established under the guidance of the NACO which implemented the
AIDS Control Programme Phase-3. It aims to provide the integrated services like,
prevention of HIV/AIDS, provide the medical treatment and care with the cooperation.
These services have been provided through the cooperation of private units; educational,
research and training institutes; citizen associations and organization of people living
with HIV/AIDS.

For the prevention and control of HIV/AIDS, multifaceted strategy, activities and
obtainments of the GSACS are below:

3.1.1 Integrated counselling and testing services

The Vatsyayan Kendra &Mamta Clinic (VKMC) provides people an opportunity to learn
and accept their HIV sero-status in a confidential enabling environment. VKMC-ICTC
has become an integral part of HIV prevention programme, as it is a relatively cost-
effective intervention in preventing HIV transmission. At the end of March 2014, there
are 1621 ICTCs (Integrating Counselling and Testing Centre) in the Gujarat out of which
309 stand alone ICTCs, 1309 Facility-ICTC (Private Partnership - PPP model, PHCs,
CHCs & Sub Centre) and 3 mobile ICTC Under ICTC. Total 941582 general clients and
778639 pregnant women were counselled and tested at ICTC on March 2014, of which
12282 found positive during the 2011-12. The tested 11282 persons were detected HIV
positive from general clients and 714 pregnant women were detected HIV positive, 785
live births were taken place and 681 mother-baby pairs received Nevirapine prophylaxis
to prevent the mother to child transmission of HIV.

HIV counselling and testing services were started in India in the year 1997. ICTCs are
mainly located in government hospitals. As of today, only 25–30% of the people who are

55
HIV positive in the country are aware of their HIV status. The challenge before us is to
make all HIV-infected people in the country aware of their status so that they adopt
healthy lifestyles and prevent the transmission of HIV to others, and access life-saving
care and treatment. Thus, counselling and testing services are an important component of
prevention and control of HIV/AIDS in the country.

HIV counselling and testing services are a key entry point to prevention of HIV infection,
and to treatment and care of people who are infected with HIV. When availing
counselling and testing services, people can access accurate information about HIV
prevention and care, and undergo an HIV test in a supportive and confidential
environment. People who are found HIV-negative are supported with information and
counselling to reduce risks and remain HIV-negative. People who are found HIV-
positive are provided psychosocial support and linked to treatment and care. Today, more
than 75,000 people who are HIV-positive access the antiretroviral therapy (ART)
programme and receive free treatment for HIV/AIDS.

An ICTC is a place where a person is counselled and tested for HIV, on his own free will
or as advised by a medical provider. The main functions of an ICTC include; 1. Early
detection of HIV, 2. Provision of basic information on modes of transmission and
prevention of HIV/AIDS for promoting behavioural change and reducing vulnerability,
[Link] people with other HIV prevention, care and treatment services.

Ideally, a health facility should have one ICTC for all groups of people. However, an
ICTC can be located in facilities that serve specific categories of people such as pregnant
women. Accordingly, an ICTC can be located in the Obstetrics and Gynaecology
Department of a medical college or a district hospital or a maternity home where the
majority of clients who access counselling and testing services are pregnant women. The
justification for such a centre is the need for providing prophylaxis to prevent the
transmission of HIV from infected pregnant women to their infants. Similarly, an ICTC
could be located in a tuberculosis (TB) microscopy centre or in a TB sanatorium, where
the majority of clients are TB patients. As TB is the commonest co-infection in people
who are infected with HIV, availability of HIV counselling and testing can help patients
to have their status diagnosed for accessing early treatment.

It is not the mandate of an ICTC to counsel and test everyone in the general population.
There are sub-populations who are more vulnerable or practice high-risk behaviour.
56
These sub-populations include sex workers and their clients, men who have sex with men
(MSM), trans-genders, injecting drug users (IDUs), truckers, migrant workers, spouses
and children of men who are prone to risky behaviour. HIV prevalence levels are
typically higher among these subpopulations than in the general population. The
personnel at ICTCs need to make concerted efforts to identify at-risk/vulnerable
populations and ensure access for them to HIV counselling and testing services. Medical
providers also refer patients who have a history of risky behaviour or have signs and
symptoms suggestive of HIV/AIDS for counselling and testing to an ICTC.

An ICTC may be located in health facilities owned by the government, in the private/not
for- profit sector, in public sector organizations/other government departments such as
the Railways, Employees' State Insurance Department (ESID), etc. and in sectors where
non-governmental organizations (NGOs) have a presence. In the health facility, the ICTC
should be well coordinated with the Department of Medicine, Microbiology, Obstetrics
and Gynaecology, Paediatrics, Psychiatry, Dermatology, Preventive and Social Medicine,
etc. As the HIV test is a relatively low-cost test and since the risk perception is generally
low, travelling a long distance to get tested could be a strong disincentive. Therefore, it is
important to ensure that facilities for counselling and testing be located as close to the
people as possible. ICTCs should ideally be located such that they provide maximum
access to at-risk/vulnerable populations. Some of the norms for setting up an ICTC are
government health sector, private/not-for-profit sector and NGO sector. There are
different types ICTCs but broadly, ICTCs can be classified into Fixed-facility ICTCs and
Mobile ICTCs. The ICTC requires a team of skilled persons consisting of the manager
(medical officer), counsellor and Lab Technician. An outreach worker would be
necessary in high-prevalence districts.

HIV/AIDS counselling/education is a confidential dialogue between a client and a

counsellor aimed at providing information on HIV/AIDS and bringing about behaviour
change in the client. It is also aimed at enabling the client to take a decision regarding
HIV testing and to understand the implications of the test results. The steps in HIV
counselling are the HIV pre-test counselling/information and the HIV post-test
counselling. HIV pre-test counselling/information involve provision of basic information
on the HIV/AIDS and risk assessment to direct walk-in clients. In the HIV post-test
counselling the client is helped to understand and cope with the HIV test result.

57
In case of a negative test result, the counsellor reiterates basic information on the HIV
and assists the client to adopt behaviour that reduces the risk of getting infected with the
HIV in the future. In case the client is in the window period, a repeat test is
recommended. Those clients with suspected tuberculosis are referred to the nearest
microscopy centre. In case of a positive test result, the counsellor assists the client to
understand the implications of the positive test result and helps in coping with the test
result. The counsellor also ensures access to treatment and care, and supports disclosure
of the HIV status to the spouse. Follow-up counselling there is a re-emphasis on adoption
of safe behaviours to prevent transmission of the HIV infection to others. Follow-up
counselling also includes establishing linkages and referrals to services for care and
support including the ART, nutrition, home-based care and legal support.

The most common and easiest way to diagnose the HIV infection is based on the
detection of antibodies to the HIV which are generated in the blood of an HIV-infected
person. Rapid tests are the most popular method of diagnosing the HIV infection. They
are user-friendly and can provide quick results to the client. A variety of rapid tests are
available and these employ different principles. The NACO recommends the use of rapid
HIV test kits in an ICTC, which provide results to the client within 30 minutes of the test.
The use of rapid test kits which detect greater than 99.5 per cent of all the HIV-infected
individuals and give false-positive results in less than 2 per cent of all those who are
tested is recommended for use in an ICTC. Testing will be done free of cost for all clients
in all ICTCs in the government health sector and in all 'stand-alone' ICTCs supported by
the NACO/SACS. A client who has a negative result in one test is declared to be HIV-
negative. A client is declared to be HIV-positive when the same blood sample is tested
three times using kits with different antigens/principles and the result of all three tests is
positive.

[Link] HIV testing and the window period

The window period represents the period of time between initial infection with the HIV
and the time when the HIV antibodies can be detected in the blood (6–12 weeks). A
blood test performed during the window period may yield a negative test result for the
HIV antibodies. These cases may require further testing after 12 weeks.

[Link] Emergency testing

58
For women with an unknown HIV status and in labour, the labour room nurses, resident
doctors, or medical officer provide basic information on the HIV/AIDS and about the
HIV testing (NACO, 2005). Thereafter, a single HIV test will be offered to determine the
HIV status of the pregnant woman and requirement for the ARV prophylaxis to prevent
mother-to-child transmission. A repeat sample will be collected and tested on the next
working day by the Lab Technician of the ICTC to confirm the HIV status. In some
situations, the patient may not be able to come to the ICTC and the blood sample is sent
from the hospital ward or other department. In this case, the ICTC should ensure that the
patient has been adequately counselled by the doctor and the blood sample is received
with a requisition slip. Post-test counselling will be provided by the ICTC counsellor in
the ward/department where the patient is admitted.

The testing of HIV transition is different from the other deceases. There must be
necessary counselling before pretesting and time of report of testing of HIV. According
to the Guidelines on HIV Testing (2007) the facilities of testing of HIV must be keeping
very secret and provide guidance them before and at the time of testing by the special
team of counsellors. The counsellors provide the status of HIV testing to individual. The
facility works as enter point of control and care of HIV. 1621 ICTCs are established in
the Gujarat state for the integrated counselling and testing of HIV/AIDS. Free of cost
counselling and testing of HIV/AIDS is available at the medical colleges, districts
hospitals, municipality hospitals, charity hospitals and community health centres of
Gujarat state. Moreover, Jindagi Ek Safar serial telecast on Doordarshan channel on
Sunday, 4:30 PM sponsored by the Gujarat AIDS Control Society is meant to spread the
awareness of the risks of HIV/AIDS.

3.1.2. Targeted intervention

The recent trend of the HIV/AIDS epidemic indicates that the epidemic has moved to the
generalized population as well. For these reasons, the principle strategy for Targeted
Intervention (TI) is total saturation of High Risk Groups (HRG) in the state. Targeted
Intervention activities have been the major activity carried out by GSACS to prevent the
spread of HIV/AIDS infection. High risk population like Female Sex Worker (FSW),
Man having Sex with Man (MSM), Transgender (TG) and bridge population like
Truckers, Single Male Migrants (SMM) are main groups targeted for various preventive

59
interventions. The targeted intervention activities have been driven primarily by non-
Governmental Organizations (NGOs) and Community based Organizations (CBOs).

The Targeted Intervention Project has been implemented with various points of view
like, to create positive environment about behavioural change interaction, to prevent the
transition of HIV/AIDS in citizens and hazardous groups like, female sex worker,
homosexuals and migrated people; and provide different services like, condom
encouragement, medical treatment of sexual deceases, counselling and care for targeted
groups under the National Aids Control Programme. The Targeted Interference Project
has been implementing with the cooperation of volunteer organizations. Commercial sex
workers and homosexuals get medical treatment of sexual deceases, condom, and
literature for awareness of HIV/AIDS etc.

3.1.3 Sexually transmitted infection care (STI) services

To reduce the prevalence of STI by Syndromic case management, involvement of private

doctors under public private partnership scheme and treatment facility for RTI/STI.
There are a total 60 functional STI clinics established in Medical Colleges, district
hospitals, some sub-district and trust hospitals. Counsellors cum Coordinators have been
appointed in each such clinic to ensure proper counselling of STI.

3.1.4 Blood safety programme

Main goal of Blood Safety Programs is to make adequate and safe blood available in all
parts of Gujarat. In Gujarat, the availability of blood is ensured through a network of 143
functional blood banks. The focus must be on promotion of repeat voluntary blood
donation, as the same is safest in terms of transfusion transmitted infections (TTIs) and
other blood transfusion related complications.

The transition of HIV virus in the 2% cases out of total cases is consequences of unsafe
blood and its products. Availability of safe blood and its products are the anxious matter
under the National Aids Control Programme. The view of the programme are that HIV
pretesting of exchanged blood for safe blood, increasing the capability of exchange of
blood in the state and cooperate to testing every blood unit of voluntary blood bank. The
GSACS have affiliated to provide testing kit only to Indian Red Cross Society and
Charitable Blood Bank out of 64 blood bank of Gujarat for the guarantee of safe blood.

60
As on Annual Report 2013-14 (GSACS, 2015) access to safe blood at the right time to
every needy person is the major objective of this programme. This has been ensured
through a network of 139 Blood Banks. Against the target of 807880 units for blood
collection, 794056 units were collected (98.3 % achievement) in which 632463 units
(79.6%) are collected through voluntary blood donation. The components separated are
447760 units (56.4%) and percentage of sero-positivity is 0.05%.

3.1.5. Voluntary blood donation

The main view of the voluntary blood donation is collecting the safe blood. The
voluntary blood donation is precious which can be donating rich and poor. Every healthy
person can donate blood regularly interval of three months. The encouragement of
voluntary blood donation has progressive through the Government and voluntary blood
bank. Educated people are interested in voluntary blood donation. Mostly, students
donate blood in colleges through National Service Scheme (NSS) and students
organization. Other people are not interested for blood donation. After finishing the
study students generally become uninterested in donating blood.

3.1.6. Information, education and communication

The State is a providing Information Education and Communication (IEC) to the masses,
mainstreaming and Behaviour Change Communication (BCC) to the vulnerable
population are the key approaches in the state. For creating awareness about prevention
and control of HIV/AIDS through various IEC activities are organized in Gujarat viz.
displaying messages in Mass Media/Mid Media, printing and distribution of brochures,
flip-charts, posters etc. The HIV/AIDS, the authorities believe can be controlled by
intense public awareness campaigns, while focusing specifically on crucial groups like,
youth, female and migrants. For these purpose various activities are being by
information, education and communication (IEC) like, group discussion, people
awareness, sensitivity and advocacy, meetings. The Gujarat state has been organizing
various programmes under the IEC like, the Integrated Rural HIV/AIDS Programme,
Jivandeep Project, catechism and essay competition, Red Ribbon club, volunteer and
proficiency education programme. The IEC program has conducted on particular days
for limited time. It is not sufficient for public awareness about HIV/AIDS. The IEC
programmes should be conducted frequently in different social groups.

61
3.1.7. The red ribbon club programme

The Red Ribbon Clubs are envisaged among all the students in the educational
institutions values of service, develop healthy life styles, and increase access to safe and
adequate quantities of blood to all the needy by promotion of Regular voluntary blood
donation. Through this programme important Health issues like drug addiction, good
eating habits, reproductive and sexual health including RTI/STI and HIV/AIDS,
voluntary blood donation promotion and stress and strain free environment are being
covered.

3.1.8. The health education and life-skill programme (HELP)

Health Education and Life-skill Programme (HELP) has been sanctioned with the
ultimate aim of wholesome development of the adolescent keeping health at the core
through increasing the capacity of the adolescent so that they can control their health by
State Coordination Committee (SCC) chaired by Principal Secretary (Education),
Government of Gujarat. The Gujarat Council of Educational Research and Training’
(GCERT) is the Nodal Agency for this programme. A comprehensive module for the
HELP has been already developed for teachers.

3.1.9 The link worker scheme (LWS)

The scheme is generating a cadre of trained local personnel as the Link Workers and
volunteers to work with the High Risk Groups (HRGs) and vulnerable young people and
women towards the: a. create an enabling environment for PLHAs and their families by
reducing stigma and discrimination through work with existing community
structures/groups, e.g. Village Health Committees, Self Help Group (SHG)etc, b. reach
out to HRGs and vulnerable young people (men and women) in rural areas with
information, knowledge and skills on the STI/HIV prevention and risk reduction, c.
establish inter linkages between gender, sexuality and HIV and bring into focus factors
that enhance vulnerability of young people and women, both in HRGs and the general
population, d. promote increased and consistent use of condoms to protect against STIs
and unwanted pregnancy, e. generate awareness and enhance utilization of prevention,
care and support programmes and services (especially STI, ICTC, PPTCT, ART, DOT
and other health services), f. facilitate the delivery of youth friendly health and
counselling services through existing public health services/service delivery points and g.

62
Facilitate the reintegration of HRGs into the community and work with families against
trafficking of women and children. The LWS is being implemented in 11 districts in
Gujarat viz; Valsad, Surat, Vadodara (Funded by UNICEF), while funded by Global
Fund Round 7 in Dahod, Surendranagar, Navsari, Banaskantha , Mehsana, Ahmedabad,
Rajkot and Bhavnagar.

3.1.10. Care, support and treatment

Gujarat has 26 districts out of which 6 are Category A districts and 4 Category B districts
and an estimated no. of 1,37,000 People Living with HIV/AIDS (PLHAs) in the age
group 15-49 years. There was only One ART Centre in 2005 at B.J. Medical College,
Ahmedabad which catered services to 1303 PLHAs.

[Link] The ART (Anti-Retro Viral Therapy) centre

According to the Annual Report 2013-14 (GSACS, 2015) in Gujarat as on March 2014
there are 277 fully functional ART Centres, with a total of 79132 patients registered in
HIV care at ART Centres, 52729 patients started on ART & a total of 39070 patients
alive on ART. The state average for LFU of on ART patients is 3412. As on March-2014,
39070 PLHA are dependent on ART in Gujarat. Out of these 4093 are being treated in
the BJMC Ahmedabad, 3908 in the NCH Surat, 2724 at the SMIMER Surat, 847 at the
Reliance Surat, 1776 at V.S. Ahmedabad, 3485 in Rajkot, 1981 in Bhavnagar, 1529 in
Mahesana, 2776 in Vadodara, 1111 in Surendranagar, 1063 in Jamnagar, 829 in Amreli,
1444 in Palanpur, 850 in Patan, 422 in Porbandar, 887 in Navsari, 1459 in Junagadh, 494
in Godhra, 1289 in Himatnagar, 1185 in Bhuj, 1508 in Nadiad, 521 in Dahod ART, 691
in Bharuch, 1179 in Valsad, 226 at Sola Ahmedabad, 168 at vyara ART centre and 625 in
Gandhinagar. Nearly five Hundred new patients are put on ART every month in the
State.

7
(1)[Link] College, Ahmedabad, (2) New Civil Hospital, Surat, (3) PDU Hospital, Rajkot, (4) Sir T.
Hospital, Bhavnagar, (5) General Hospital, Mahesana, (6) Reliance Industries Hazira, Surat, (7) SSG
Medical College & Hospital, Vadodara, (8) Mahatma Gandhi Hospital, Surendranagar, (9) GG Hospital,
Jamnagar, (10) General Hospital, Junagadh, (11) G.K. General Hospital, Bhuj, (12) SMIMER Hospital,
Surat, (13) General Hospital, Palanpur, (14) V.S. Hospital, Ahmedabad, (15) Sir Pratap General Hospital,
Himmatnagar, (16) General Hospital, Navsari, (17) General Hospital, Amreli, (18) General Hospital, Patan,
(19) General Hospital, Porbandar, (20) General Hospital, Godhara, (21) General Hospital, Bharuch, (22)
General Hospital, Valsad, (23) General Hospital, Dahod, (24) General Hospital, Nadiad, (25) General
Hospital, Gandhinagar, (26) Sola Civil Hospital, Ahmedabad, (27) Vyara Civil Hospital, Tapi.
63
[Link] The link ART centre (LAC)

At Taluka Level, ART is available through the Link ART Centres which is nearer to the
home of patient. Till the end of March 2012, 40 LACs are Functioning in Gujarat. The
HIV infected people can be lived long and healthy life before the manifestation of
symptoms of AIDS. AIDS is the last stage of transition of the HIV virus. It is controlled
by ART which increase immunity power of person against it attack. Of course, it does
not necessary to every HIV infected persons. Around 10% HIV infected persons must be
taking ART. which can helpful for qualitative long life.

The first ART centre has established in 2005 in the Gujarat state. After that it established
in the Ahmedabad, Surat, Vadodara, Rajkot and Bhavnagar districts for free treatment to
HIV infected persons. Gujarat is the only state who established the five link centres in the
above five district for maximum use of the service.

3.1.11 Suraksha clinic (STD/STI Clinic)

GSACS supports 63 designated STI/RTI clinics at District hospitals/PHC/CHC and 135

STI Clinics in Targeted Interventions at the end of March 2014. Against the annual
target of managing 234590 STI/RTI episodes in patients, 119135 episodes were managed
till 31st March 2014. The larger numbers of clients are covered under STI programme as
we have extended the STI facilities up to CHC and PHC level during the year. The STI
services are being expanded through involvement of targeted intervention projects.

3.1.12 Strategic information management unit (SIMU)

SIMU Evidenced based planning has been identified as backbone of halting and
reversing the HIV epidemic under National AIDS Control Program-3 (NACP-3).
Accordingly, a Strategic Information Management Unit (SIMU) has been established in
the state to maximize effective use of all available information and implement evidence
based planning. SIMU integrates all sources of information and presents logical and
rational strategic information useful for decision making. The output from SIMU
addresses strategic planning, monitoring and evaluation, surveillance and research and
assist GSACS in tracking the epidemic and the effectiveness of the response as well as
assess how well GSACS and its partner organizations are fulfilling their commitment to
meet agreed objectives.

64
3.1.13 Launch of strategic information management system

During the execution of NACP-3 it was felt that the data from HIV Sentinel Surveillance
and Computerized Management Information System (CMIS) are not sensitive enough to
detect the emerging hot spots of the epidemic because the data entry is offline. To
overcome this NACO has introduced Strategic Information Management System (SIMS)
on-line system at national and state levels to focus on strategic planning, monitoring,
evaluation, surveillance and research. It is aimed to provide effective tracking and
response to HIV epidemic. This system assigns clear responsibilities to all programme
officers and facilitates data flow and feedback at various levels. Also being on-line data
entry in SIMS, the data accessibility at each level will increase. It is very helpful for
future strategies against HIV/AIDS.

3.1.14 Jivandeep project

The Jivandeep Project has been implementing for inclusion of people living with
HIV/AIDS in main stream of the society. It aims to create healthy and positive
environment for the people living with HIV/AIDS at state and district level. So that we
can be widespread misunderstandings, stigma, discrimination and silent behaviour related
to HIV/AIDS. The main strategy of the project is to accelerate the programme with
control the HIV/AIDS by advocacy, networking and positive prevention through
involvement of the people living with HIV/AIDS.

The Jivandeep Project has been implementing all the districts of the Gujarat state. Its
major activities are: Advocacy and sensitive meetings, Networking, Positive Speaker
Bauru, Counselling and advice related to HIV/AIDS.

3.1.15 Mamta clinic:

The children less than 15 years infected by HIV/AIDS through their parents. The
probability of transition of HIV in child through mother has been 30 to 40% but the
probability of transition of HIV can be reduced almost 7% by the dose of Nevirapine8 to
child and mother during the delivery of child. Moreover, infected mothers have
encouraged preventing the transition of HIV and testing. The programme has support to

8
Nevirapine is a drug used as part of anti-retroviral therapy (ART).
65
identify HIV infected mothers and their follow-up. It has ensured the dose of Nevirapine
to child and delivery in clinic to reduce transition of HIV in nascent child.

Mamta centres have activated for the prevention of transition of HIV virus in child from
mother. The Mamta centres have activated in the medical colleges, district hospitals,
municipality hospitals, charity hospitals and community health centres. These centres
have providing the guidance to pregnant women, various testing during pregnancy and
dose of Nevirapine to nascent child free of cost.

3.1.16 Awareness movement for women

There is high proportion of HIV in women. There is more probability of infection of HIV
in women because of less awareness about HIV/AIDS, lower social status and biological
structure of women. There are 40% women out of total HIV infected people. So there are
various programmes have introduced to reduce the hazardous situation in women by
“National AIDS Control Society”. “Tejswini Week” has been celebrating in the state to
increase awareness in women and to make sensational them under the opportunity of
“World Women Day”. Tejswini means to develop the capability to protect against HIV
virus.

3.1.17 Drop-in centre

HIV infected people have been feel psychological stress and social tension. They should
have some secret places where they can be receive cooperation and guidance. The “Drop
In Centres” are the place where HIV infected people can be help each other through
articulate their feelings and expression. The Centres established under the National Aids
Control Programme. Mostly the “Drop-in Centres” have operated by the people living
with HIV/AIDS. “Drop-in Centres” have been established in some big cities of Gujarat
state. Moreover, associated structure has established in 20 districts under the Jivandeep
Project. The “Gujarat State Network of Positive People” is the state level organization
which is affiliated to “Gujarat State AIDS Control Society” and district level network
raised by it.

3.1.18 The world AIDS day

The 1st December is celebrated as “World AIDS Day”. The day celebrates by different
activities of awareness where policy makers, planners, implementers and social workers
66
together demonstrate the unity against the control the HIV/AIDS. Rally, Demonstrations,
Competitions and Workshops have planned on this day. Health and medical authority
associations, affiliated associations, network of positive people, students of school and
colleges have participated very enthusiastically.

3.1.19 Introduction to Gujarat state network of people living with HIV/AIDS

(G.S.N.P+)

The Gujarat State Network of People Living with HIV/AIDS is a powerful and
inspirational state level organization which is contributing in control and cure of
HIV/AIDS. The attempts of HIV infected people against national resistance of
HIV/AIDS are notable. Gujarat State Network of People Living with HIV/AIDS has
established in 6th February, 2003 by 7 HIV infected people for to bring out their problems
and discriminations to Public. The aim of G.S.N.P.+ is to create a favourable and
influential environment where HIV infected people can lived, to get proper treatment
without stigma and discrimination, to protect their human rights and social safekeeping.
The G.S.N.P. plus working through their district level organization of 24 districts in
Gujarat state.

The “Jatan Project” is implementing in 18 districts of the Gujarat State. Its aim is to
motivate the HIV infected people for HIV testing of their children. They provide ART;
medical treatment and take care in the cases of HIV positive testing of children.
Moreover, they attempts for identify and resolve the problems of children living with
HIV and HIV infected people. The main activities of this organisation are: special child
care for HIV infected orphaned children; provide Rs. 500 under medical assistant
scheme, marriage bureau for HIV infected people, educational assistant, grain assistant to
poor people, support group meetings (celebrates to different festivals and planning of
various competitions), provide counselling, Planning of awareness programmes, provide
various services with the alliance of governmental/nongovernmental associations,
planning of income generated activities through create of self-help group, planning of
different activities for the creation of encouraging environment, attempts to protect
human rights of HIV infected people and advocacy for total medical treatment and
provide free legal assistant to HIV infected people.

67
3.1.20 Government schemes for HIV positive people

 Monthly assistance of Rs. 500 to HIV positive SEBC and OBC people for
nutritional food.
 Monthly assistance of Rs. 500 to HIV positive widow who possesses the BPL
ration card and additional assistance for Rs. 80 for child till the age of 18 years.
 Including in the Antyodaya Scheme to HIV positive person who possesses the
BPL ration card.
 Transport allowance to HIV positive person for going to ART centres and Rs. 100
cash assistance with transport allowance to parents of HIV positive child.
 Provision of scholarship of Rs. 27.42 lacs per year for HIV positive and HIV
infected students by Social welfare Department.
 Established the orphanage at Surat and Gandhinagar by Social welfare
Department for HIV positive orphaned children.
 There are special provision of leave for students to go the A.R.T. centres and
medical treatment.
 Rs. 1000 monthly assistance under the new scheme of assistance to guardian of
orphaned children.
 The Jivandeep project has been operating for bring out the matter of HIV in the
main stream of society by people living with HIV/AIDS.
Government pay monthly assistance of Rs.500 to HIV positive SEBC and OBC people
for nutritional food. But, this assistance is not deposited regularly in bank account of the
people every month. Also it is not sufficient money for HIV positive people for
nutritional food. Government should provide more help to HIV positive people and their
family.

3.1.21 Adhar organization

The Adhar organization is operated by HIV positive people. It established in 2004. The
meaning of Adhar is ‘shelter’ or ‘support’. Members of the Adhar organization have
indicating support and warmth to each other and fulfilled the name of the Adhar
organization. The Adhar organization have starting with only 10 members but now it
becomes very gigantic with 1700 members. It is registered as charitable trust in 2005
which will be operating in the direction to protect their human rights and eliminate the
discrimination against HIV positive people. The Adhar organization operates under the
68
guidance of the Project Director, AIDS Control Society funded by Ahmadabad
Municipal Corporation and doctors of civil hospital. Any individual cannot be living in
isolation, the thought strengthen the organization. Every member of the Adhar
organization is important part like a part of family. Thus she/he becomes a part of social
and external environment of society. The Adhar organization makes their members
powerful by inspirational living. The main objective of the organization is to, create an
atmosphere for HIV positive people to solve their economic, social and mental problems
through sensibility of society. So they can live without any discrimination and protects
their human rights. They have planned different activities with specific aims. It aims to
strengthen with the positive approach of life through organization of HIV/AIDS positive
people. It attempts to make economically sound and they can live in society with
respectfully, to set up educational assistant for better future of their children, to empower
them in the account of their physical, mental and emotional necessities and involve the
HIV positive people in the process of decision making to implementation.

3.1.22 Organization of people living with HIV/AIDS in Ahmedabad district

Ahmedabad District Network of Positive People (ABAD N.P.+) is the organization of

people living with HIV/AIDS of Ahmedabad district which aided by the GSACS. The
ABAD N.P.+ is the organization which functioning of HIV positive rural and urban area
people of Ahmedabad district. The “Kaira Social Service society” is the other
organization which is functioning for Christians. Some other organizations are also
functioning in this area.

ABAD N.P.+ means Ahmedabad Network of Positive people. It established in May, 5,

2005 which is functioning in the Ahmedabad district. The HIV positive people living in
the villages and city of Ahmedabad are the members of the organization which aided by
the GSACS. The organization is functioning with specific goals like, to be of assistance
for health and long life of the HIV positive people, solve their problems by removal of
discrimination and disgrace and prevent the new cases of HIV/AIDS.

Major Activities of ABAD N.P.+ are : (a) Provide transport allowance under the Jatan
Project to HIV positive people who are coming at the A.R.T. centre to take the
medicines. (b) Provide the grocery under the Antyodaya Scheme to family of HIV
69
positive people who are living below poverty line. (c) Provide Rs.500 per month for
nutritional food to socially backward HIV positive people. (d) Provide Rs.500 per month
to HIV positive widow who are living below poverty line and Rs.80 per their every child.
(e) Provide scholarship to HIV positive students. (f) There is provision of special leave
for HIV positive students by education department. (g) There is facility of orphanage in
the Gandhinagar and Surat cities for orphaned children after the death of their HIV
positive parents. (h) Provide the assistant of Rs. 1000 per month under the Guardian
scheme to guardian of HIV positive orphaned children. (i) The organization is
functioning to protect under the provision of human rights to the HIV positive people
against problems, disgrace and discrimination.

3.1.23 The Kaira social service society

The Kaira Social Service society has been working for last 44 years for needy and
deprived people by human right and special advantage without any discrimination of
race, religion, sex and caste. The organization inspired by the removal of poverty, human
grace, social justice and establishment of peaceful society under the theory of social
work. The organization is functioning for women empowerment, disaster management,
education, farming, child rights, health, save the girl child, HIV/AIDS with the
programme of social justice and peace.

The Kaira Social Service society is functioning in Anand, Kheda, Ahmedabad and
Panchmahal. The organization plans the programmes to be creating sympathy to all
religions. The children, women, youth, teachers, religious leaders and dignitaries are
active in these activities. The organization has registered as Kaira-F-109 under the Trust
Act and Guj/207/Kaira under the Society Act which active from 1967. The point of view
of the organization is that to create a society where nurture the social values like, social
justice, peace, love, equality and people living closely to nature.

3.2 Prevention and Control of HIV/AIDS and the Social System

It is a fact that there is no permanent cure for HIV/AIDS. Only a good awareness of the
risks involved is helpful to prevent and control of the HIV/AIDS. People of India feel shy
and hesitant to discuss their health and sexual problem with other persons. Such a
situation creates many issues and problems in the society. People are not involved in the
process of HIV/AIDS awareness campaign easily due to fear of stigma and
70
discrimination. So, government cannot success in their programs regarding control,
prevention and awareness of HIV/AIDS. Society maintains its system by controlling the
problematic situation. The attempts have been done at the world level, regional level and
local level for to prevent the diffusion of the HIV/AIDS and respectful acceptance of the
HIV positive people in society. Thus, the attempts have been done at different level of
society. The HIV/AIDS does not only a problem but it becomes a social problem which
can be examined in the social science perspective. The facts and understanding of the
Indian society in the reference of HIV/AIDS described below on the basis of review of
literature, field work and experiences during research process of the present research.

3.3 Informal Norms and Values

The traditional norms and values are still dominated in the current Indian social system
which is the directive of the human behaviour. The norms regarding to sex are very rigid
than other societies of the world. The sexuality of women is connecting to the concept of
sacred. So the individuals couldn’t talk freely about sexuality in the social background
and the topic of sex education didn’t include in the education system in most of states of
the India. Therefore, the scientific attitude and thoughts couldn’t be created still in the
India. The thoughts about norms of sexuality haven’t change in India. The women of
India become the victim of HIV/AIDS and sexual decease because of the lack of freedom
compare to men. When the men and women become the victim of HIV/AIDS they
disgrace by society and suspicious about their behaviour in the reference of norms of
sexuality. He/she must be done some wrong work, so become the victim of HIV/AIDS- it
is the generalizing thought of the Indian society. The sacredness of women connects with
the values of sexuality in the Indian society. The disgrace and discrimination has been
starting when she becomes the victim of HIV/AIDS and people behave as she is profane.
When the person suffers from diabetes and blood pressure, he receives the sympathy and
cooperation from the society but can’t receive in the case of the victim of HIV/AIDS. So
the thoughts about the norms of sexuality in the Indian society make HIV/AIDS a social
problem.

3.4 Family and HIV/AIDS

Family is the crucial unit of Indian society which plays the important role in the
socialization of child. If the individual of joint family becomes the victim of HIV/AIDS,
then he/she must be lived in separate household which is noticed during field work. They
71
remove from kins when the HIV positive people indeed need for cooperation, sympathy
and love of family members. Thus, their social relations weakened. The HIV positive
who lives in separate household suffered many problems like, they didn’t give their part
of property, they must be lived in house with rent etc. The importance of family in India
is more than other countries and it can be seen equally in joint as well as nuclear family.
The cooperation has seen at highest level in both kind of family. They solve the problem
with the cooperation of each other at bad times and problematic situation but HIV
positive person couldn’t get this kind of cooperation by his family. So he/she experienced
the feeling of loneliness. Thus, the family system has related to the problem of
HIV/AIDS. Moreover, it didn’t cover up in the process of socialization because lack of
sex education. Thus, the members of family discrete from the true knowledge of
HIV/AIDS and become the victim of HIV/AIDS. Furthermore, the individual feels shame
and hesitation to talk it to family members in the situation of sexual decease. This kind of
social environment has been seen in the Indian society and particularly in the family
system. Therefore the problem of HIV/AIDS can be examined in different perspectives in
the Indian society.

3.5 Marriage and HIV/AIDS

Marriage as an institution is important institution in the Indian society which is relates to

the norms of sexuality. Marriage legitimates the sexual behaviour in the Indian society.
Generally restriction of pre marriage sexual relations has been seen and people couldn’t
talk about sexual relations and sexual necessities in the Indian society because of the
thought being the rites of marriage allied to religion which makes the sexual relations as
sacred. The people feared of society to satisfy their sexual necessity even in the situation
of ill-matched marriage, late marriage etc. So sometimes they initiate the unsafe sexual
relation with fear of society and lack of true sexual knowledge. The true and scientific
knowledge can be created in the Indian society, if the norms of sexuality must be discrete
from marriage and religion and it must be accepted as a biological necessity of people.
This kind of thinking plays important role in the prevention of diffusion of HIV/AIDS.

3.6 Educational Institutions and HIV/AIDS

There is lack of sexual education in both forms of education in the Indian society. There
are control or restriction on sexual education in most of the states of India including to
Gujarat state where restriction on the scientific sexual education in the schools. In fact,
72
the education system must be relates to the values of scientific knowledge but the current
scientific education system clearly influenced by the Indian society and traditional
religious norms. The education system plays important function of socialization in any
society and nowadays it become more important than family institution. Even the
importance of education and scientific knowledge has increased in current times, though
traditional norms of sexuality have seen in the current education system of India. So, the
youth and the women couldn’t obtain the sex education at proper age. Thus, the diffusion
of HIV/AIDS has increased because the lack of scientific knowledge about HIV/AIDS,
safe sexual relation, use of condoms and sexual deceases. So the education system of
India must be accumulated the scientific and objective knowledge. This kind of
transformation of education system of India will useful in the solution of not only of
HIV/AIDS but many other problems of society.

3.7 Economic Institutions and HIV/AIDS

The diffusion of HIV/AIDS hurts the youth in the situation and it makes weakened the
Indian economy. So we must be prevent the problem of HIV/AIDS, otherwise our
economy can’t become developing. The people can’t be engaged in their business or job
with full of satisfaction, they become dependents, their economic condition become
weaker because of this kind of viral deceases which is hindering the development of
economy. Thus, the problem of HIV/AIDS hurts the developing country like, India.

3.8 Indian community and HIV/AIDS

Although the HIV positive people suffer from discrimination and disgrace in social
conditions that make them in a situation of isolation. According to Durkheim (1897), it is a
situation of anomie that eventually leads to suicide or deviant behaviour. The feelings
and sympathy have been present in the interaction in the birth to till the end of life of the
Indians but lack of the feelings and sympathy in the interaction with the HIV/AIDS
positive people leads them towards to disparity and courage less. They feel the loneliness
and become mentally disturb because of lack of cooperation from the primary groups in
such social situation. In fact, they expect more than cooperation from the primary groups.
But the discrimination and accusation by the primary groups when they suffer from
HIV/AIDS are dysfunctional for the Indian society.

3.9 Conclusion
73
Gujarat is implementing various programmes in coordination with various departments
such as Health & Family Welfare, Women & Child Development, Education, Labour,
and Home. The programmes discussed above are implemented in Gujarat during the third
phase of the National AIDS Control Programme. All these programmes are working for
HIV/AIDS awareness, prevention and control. Government has taken many paces for
prevention and control of HIV/AIDS, but there are many socio-cultural barriers.

The goal of the third phase of the National AIDS Control Programme in Gujarat is to
make sure that all citizens get aware of HIV/AIDS. For this GSACS implemented many
programmes like the ICTCs, Targeted Intervention, Sexual Transmitted Infection Care
Services, Blood Safety Programme, Information Education Communication etc. But it is
not enough for achieving awareness of HIV/AIDS. For example, IEC programme is
working for awareness in students of schools and colleges. But there are many children
who are not go to school and college. For this reason government should take pace for
awareness about HIV/AIDS in those children who do not go to school or college.

The State Governments at their levels should develop strong ownership of the HIV/AIDS
prevention and control programme. As the prevalence of the HIV/AIDS and its
implications different from State to State, the state governments should formulate their
own strategies and programmes for tackling the HIV/AIDS. In educational institutions
AIDS education should be provided through curriculum approach. The programme of
HIV/AIDS education in schools and the Universities programme should have universal
applicability throughout the country in order to mobilise large sections of the student
community to bring in awareness among themselves and as peer educators to the rest of
the community. Non-student youth should also aware through the large network in the
country. AIDS prevention education should also be integrated into the programmes of
workers education and different schemes of social development.

A massive media campaign was launched by the NACO in 1996 through well designed
generic materials. Posters, pamphlets, booklets, newspaper advertisements, film
clippings, TV spots, radio spots, wall paintings and cinema slides etc. were prepared in
Hindi and in all regional languages. Government of Gujarat is trying for awareness of the
HIV/AIDS through media, but there are many villages in the state which are not
connected with rural and urban area, not connected with electricity. Many people of the
state are not watch Television programmes or not listen-in Radio programmes or not read
news paper or magazines or posters or pamphlets; many people who watch Television
74
and listen Radio cannot understand or do not pay attention to the massages given in
advertisement by government because of issues from illiteracy or language barriers to the
unattractiveness of the advertisements. Therefore the government should plan puppet
shows, folk dances, street plays etc. which are more compatible to local socio-cultural
atmosphere for better awareness of the risks of HIV/AIDS.

Moreover, the public attitude towards HIV positive persons is highly discriminatory and
exclusionary. The GSACS has taken initiative to remove the stigma and discrimination
with HIV positive person. If people accept HIV positive persons and behave without any
discrimination and express sympathy, they will not hesitate to get treatment. But it is
very tough. If such a conducive and welcoming ambience is created, work for prevention
and control of HIV/AIDS will be very easy. For this, government should make effort to
create proper knowledge about the HIV/AIDS in society. In short, if people may accept
those who are HIV positive, their fear of decline of social status will be removed and
they will always be ready for treatment procedure. This may be helpful to
decrease/reduce new infections in society. If any person gives blood for HIV testing in
PHC or CHC or District Hospital nearby his/her residential place and detect HIV
positive, the person does not come a second time for treatment and counselling because
of fear of social stigma. He/she goes to another district for HIV testing for a second time.
In this situation the same person gets registered twice in government record. Therefore,
government cannot found the actual number of HIV positive people, and it can be a
hindrance to the government to plan the programmes and campaigns. Discrimination and
stigma should be removed from mind of people. These may be very helpful to control
and prevent of HIV/AIDS.

All over the discussion it has been revealed that there are not any perfect method for
control and prevention of HIV/AIDS. There are many reasons, which are
barriers/obstacles in achievement of government’s goal. Government conducts many
programmes for awareness for all people of society. But still there are many people are
not covered in government’s campaign. So government should formulate strategies
which cover each and every person of the society. For this, government should provide
knowledge about HIV/AIDS at workplaces and local places. Those people who are
associated with farming, agricultural labour, industrial labour and other activities also
should be made aware of HIV/AIDS. For this, government should take more effort for
seriously involving people with leadership qualities from every walk of life.

75
It is true that the HIV/AIDS awareness campaign is a social liability. The control and
prevention of HIV/AIDS is not the responsibility only of health professionals but it is a
responsibility of each and every member of the society. Maximum involvement of people
in HIV/AIDS campaign is very necessary to save society from the HIV/AIDS. For this,
government should take more effective measures for greater public engagement with and
citizen participation in awareness programmes. Sensitivity towards micro-sociological
contexts and sites from a contextualist framework is essential to charting out effective
awareness campaigns and programmes.

76