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Punjab AIDS Control Program

Overview

The “Enhanced HIV/AIDS Control Program” is under implementation since December 2003. The first phase ended in December, 2008. During the second phase (2009-13), implementation of the PC-1 was started in January 2009.

The implementation of the second phase (2009-13)  PACP will contribute towards achieving the following objectives by 2013:

  1. To control or reverse the spread of HIV among the most at risk groups and to keep the epidemic from establishing among the bridging groups and the general population.
  2. To create an environment in the country where People Living with HIV can access medical and social services and enjoy life without facing stigma or discrimination.
  3. To coordinate a multisectoral, comprehensive and sustainable response to HIV that is based on evidence, transparency and accountability and involves the various line ministries, the civil society and the main target beneficiaries (the PLHIV and the most at risk groups).

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Program Components

The components of the present phase are depicted as below:

  • Interventions
    • Targeted Interventions for most-at-risk populations and bridging groups.
    • HIV Care and Support
    • Blood Safety
    • Control of Sexually Transmitted Infections
    • Prevention of Parent to Child Transmission.
    • Voluntary Counseling & Testing
  • Advocacy & Communication
    • Advocacy
    • Communication and Stigma Reduction Campaign
  • Governance & Institutional Framework
    • Governance
    • Capacity Building
    • Programme Management
    • Monitoring & Evaluation of HIV Response

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Implementing Mechanisms

  • To provide comprehensive HIV treatment and care services for adults and pediatric cases including free antiretroviral therapy, management of opportunistic infections, voluntary counseling and testing (VCT) services and management of acute/chronic care of HIV related infections to HIV + people and their families.
  • Follow up and monitor treatment related adverse effects, toxicities and provide medical and psychological support in understanding both the disease and treatment demands.
  • Provision of integrated PPTCT interventions in MCH facilities for all HIV+ women and their families including risk screening, counseling and safe infant feeding options.
  • Availability and access to advanced HIV diagnostics such as CD4 and HIV viral load testing.
  • Promote linkages with referral services (hospital based services), community organizations/NGOs and people living with HIV/AIDS (PLWHA) to enhance access to care and other support services (i.e. nutritional, financial, social)
  • To reduce stigma of HIV through acceptance of HIV + people and create awareness of HIV as a treatable chronic medical condition.

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Understanding the HIV and AIDS Epidemic

An HIV/AIDS epidemic is defined by the HIV prevalence in the general population, which is the percentage of the population living with HIV. An epidemic is either generalised (HIV prevalence is 1% or more in the general population), concentrated (HIV prevalence is below 1% in the general population but exceeds 5% in specific at-risk populations like injecting drug users or sex workers) or low level (HIV prevalence is not recorded at a significant level in any group).

In Punjab as in the rest of the country, there is a concentrated epidemic According to the preliminary report of Round 4 of HIV/AIDS Surveillance Project (HASP),the prevalence in IDU’s is 37.8%,Hijra sex workers 5.2%,Male sex workers 3.1%,and Female sex workers is 0.6%.

Reported HIV Diagnoses

With reported diagnoses, each number indicates an actual positive result for a person's HIV test. This method of looking at an epidemic can give an extremely clear picture in terms of real people who have been affected by the virus, especially when looking at smaller areas. However, it is often not a reliable way of assessing wider trends because many people living with HIV have never taken an HIV test, and not all diagnoses are reported. However, even in these countries, there are significant numbers of people who have never taken a test and remained undiagnosed

Another point to remember is that looking at the years in which people tested HIV positive does not tell you when they were infected - the test itself may come many years after infection occurred. And when looking at HIV reports, it's important to keep in mind that there might be more than one reason for trends in the data. An increase in diagnoses might not mean that more people are becoming infected with HIV than in previous years - it might mean, instead, that HIV testing has become more easily available than in recent years, or that stigmatisation of people living with HIV has declined, so more people are willing to be tested.

Estimated HIV Prevalence

According to UN estimates there are 97,000 to 1, 25,000 HIV Positive persons in Pakistan. Thus there is an estimated 50,000 PLHIV in Punjab. However the total number of reported HIV Positive cases in Punjab is 2926.

In most cases, HIV prevalence cannot be accurately determined from reported cases because many infections are undiagnosed or unreported. The best estimates are mainly based on the results of surveys of large groups of people.

In a country with a generalised epidemic (a high level of infection in the whole population), the national estimate of HIV prevalence are usually mainly based on surveys of pregnant women attending antenatal clinics. Many studies have shown that HIV prevalence among pregnant women attending clinics is generally very similar to prevalence in the adult population as a whole.According to R4 report, the prevalence of ANC is 0.003%.

Population based surveys are useful because they tell us how prevalence varies according to gender, race or other characteristics, but they are usually not the main source of national prevalence estimates. One reason for this is that population based surveys are much more complicated and expensive than antenatal surveys

In a country with a low-level or concentrated epidemic (where high levels of infection are found only in specific groups), the national estimate of HIV prevalence is mainly based on data collected from populations most at risk - usually sex workers, injecting drug users or men who have sex with men - and on estimates of the sizes of the populations at high risk and at low risk. Reports of HIV diagnoses and AIDS deaths may also be taken into account.

Estimated HIV Incidence

'HIV incidence' is the number of new HIV infections in the population during a certain time period. People who were infected before that time period are not included in the total, even if they are still alive.

National estimates of HIV incidence are usually produced by computer models and are based on estimates of HIV prevalence. Such models apply a set of assumptions such as the survival time of those infected with HIV and the mother-to-child transmission rate. Trends in HIV prevalence among teenagers and young adults can give a rough idea of incidence because infections among this group are likely to have been recently acquired.

Understanding HIV Prevalence and Incidence Trends

In the early years of a typical HIV epidemic, prevalence increases rapidly because more and more people are becoming infected and few are dying. However prevalence cannot increase forever - eventually the death rate (number of deaths per year) rises to equal the incidence rate (number of new infections per year), and so prevalence reaches a peak.

A rise in HIV prevalence is not necessarily a sign of failing prevention campaigns. Besides a rise in incidence, it could result from any of the following:

  • The death rate has fallen because of improvements in treatment and care (this has happened in high-income countries).
  • The death rate has fallen because fewer infected people are dying as a result of war, famine or other causes that had disproportionately affected people living with HIV.
  • The death rate has fallen as a result of an earlier drop in incidence (on average, people survive for a number of years after becoming infected, so incidence trends have a delayed effect on death trends).
  • More people living with HIV are immigrating than are emigrating (this affects a number of high-income countries).
  • The survey bias has changed.

Equally, a fall in HIV prevalence is not necessarily a sign of effective prevention campaigns, as it could result from an increase in the number of deaths.

It is even possible for HIV prevalence to increase at a time when HIV incidence is decreasing - for example, in a society that is rapidly scaling-up antiretroviral treatment provision while also making improvements to prevention activities. The drop in the number of new infections might then be outweighed by the effect of people living longer.

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Details of Services Available

  • Medical Care
    • HIV/AIDS related medical care (acute and chronic management of HIV/AIDS)
    • Management of Opportunistic infections
    • Provision of Antiretroviral therapy (ART)
    • In-patient ward admission facility
    • Referral to specialist services (i.e. medical, surgical, pediatric, obstetrics-gynecology, psychiatric, dental etc)
    • Pediatric care
    • PPTCT interventions including C-section, safe delivery, infant feeding counseling, and ARV prophylaxis
  • Counseling Services
    • Pre-test counseling
    • Post-test counseling
    • Individual, couples, family and group counseling
    • Out-reach peer counselors (PLWHA volunteers)
    • Referral to COs/NGOs for social support services and PLWHA groups
  • Laboratory/Diagnostics
    • HIV ELISA
    • CD 4 and HIV viral load PCR testing ( only available at PIMS, Shaukat Khanum Hospital and Sindh Services Hospital)
    • General laboratory diagnostics
    • Radiological support
    • Facility to send out specialized tests to NIH reference laboratory
  • Pharmacy
    • Inventory of Antiretroviral medicines
    • Medications for opportunistic infections & STIs including some common antibiotics
  • Nutritional Counseling
    • Daily caloric requirements
    • Efficient utilization of resources to meet caloric requirements
    • Healthy lifestyle choices
    • Educational materials
    • Referral to nutritional support opportunities if needed

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Contacts

Office of Punjab AIDS Control Program
First Floor,5 Montgomery Road,Lahore
Phone no: 042-99201098 / 042-99200982
Fax No: 042- 99203394

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HIV/AIDS Treatment Centers

  • Special clinic OPD Room no 4
    Mayo Hospital Lahore
    Ph #:042-37048843
  • Special clinic OPD Room no 34
    Jinnah  Hospital Lahore
    Ph #:042-99231400-23
  • Special clinic Medical Unit IV,
    Services/SIMS Hospital, Lahore
    Ph #:042-99203402-24 ext 3068
  • Special Clinic for Children, Pediatric Unit 1
    Services/SIMS Hospital, Lahore
    Ph #:042-99203402-24 ext 3208
  • Special clinic, Medical OPD
    DHQ Hospital, Sargodha
    Ph #: 048-9230569
  • Special clinic, Medical OPD
    DHQ Hospital, Dera Ghazi Khan
    Ph #: 064-9260224
  • Special clinic, First Floor Emergency Ward
    DHQ Hospital, Gujrat
    Ph #: 053-9260101-5
  • Infectious Disease Clinic
    Shaukat Khanum Hospital, Lahore
    Ph #: 042-35945100-9

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Voluntary Confidential Counselling and Testing (VCT) Centers

  • VCT Center,
    Services Hospital, Lahore
  • VCT Center,
    Government Said Mitha Hospital, Lahore
    Contact No. 0331-4123957
  • VCT Center,
    DHQ Hospital, DG Khan
  • VCT Center,
    DHQ Hospital, Sargodha
  • VCT Center,
    Allied Hospital, Faisalabad
  • VCT Center,
    Nishtar Hospital, Multan
  • VCT Center,
    DHQ Hospital,Gujrat
  • VCT Center,
    THQ Hospital, Jalalpur Jattan, District,Gujrat
  • VCT Center,
    Benazir Bhutto Shaheed Hospital,Rawalpindi.
    Contact No. 051-5564008

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HIV/AIDS Surveillance Centers

  • Institute of Public Health,
    Lahore
    Ph #: 042-37500482
  • Pathology Lab, Jinnah Hospital,
    Lahore
    Ph #: 042-99231400-23
  • Main Clinical Lab, Mayo Hospital,
    Lahore
    Ph #: 042-99211100-9
  • Pathology Lab, Allied Hospital,
    Faisalabad
    Ph #: 041-99210095
  • Department of Pathology, Nishter Medical College,
    Multan
    Ph #: 061-9200234-37 ext 2068
  • Pathology Department, BV Hospital,
    Bahawalpur
    Ph #: 062-9250435
  • DHQ Hospital,
    Sargodha
    Ph #: 048-9230341-2
  • DHQ Hospital,
    DG Khan
    Ph #: 064-9260220
  • Sheikh Zayed Hospital,
    Rahim Yar Khan
    Ph #: 068-9230161
  • DHQ Hospital,
    Jhelum
    Ph #: 0544-9270258
  • DHQ Hospital,
    Gujranwala
    Ph #: 055-9200109-10
  • DHQ Hospital,
    Gujrat
    Ph #: 053-9260101-5

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List of PPTCT  Centres

  • PPTCT Coordinator
    PPTCT site,Gynae Unit 3
    Services Hospital, Lahore
    Contact No.042-9203402-24 ext 3090
  • PPTCT Coordinator
    PPTCT Site, Gynae Unit 2
    Lady Willingdon  Hospital, Lahore
    Contact No.042-7659001 ext 2448
  • PPTCT Focal Person,
    PPTCT site,Gynae Department
    DHQ Hospital, Gujrat
    Contact No.053-9260115
  • PPTCT Coordinator
    PPTCT site,Gynae Department
    DHQ Hospital, D.G.Khan
    Contact No.064-9260224

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Oraganogram (Click Here)

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Site Last Updated: 23rd November 2017