Abstract no. A-641-0408-07370 Social entitlements of PLHIV/AIDS in ANDHRA PRADESH A. Sawhney 1, K. Bodducherla 2, D.P. Yerramasetti 3, J.K. Kurada 4, R. Bolli 5, S. Siddhartha 6
Background HIV epidemic remains a major public health challenge not only at the country level but also at our State level. Out of the estimated 20.9 Lakhs of People Living with HIV/AIDS (PLHIV) in the country, Andhra Pradesh happens to be the State inflicted the most contributing about 20% of the total country load with an estimated 4.9 Lakhs People Living with HIV/AIDS in AP alone. Andhra Pradesh contributes the highest disease burden not only in terms of prevalence (20% of total cases inclusive of both old and new) but also in terms of new infections (14% of all new cases) occurring in India Current Statistics Globally approx.: *source UNAIDS 2013 Fact sheet Total people infected with HIV 3.53 Crores Adult people infected with HIV 3.21 Crores Women living with HIV 1.71 Crores Children living with HIV(<15 Years) 33 Lakhs Indian Scenario as per source -2012 Median Estimations Report, NACO Number of people living with HIV 21,00,000 Adult people infected with HIV 19,00,000 Women living with HIV 7,50,000 Adults (15 to 49 years) prevalence rate 0.3 % Andhra Pradesh Scenario: Estimated PLHIV- 5 lakhs *source CMIS State program data up to Dec 2013 HIV Cases registered in the year 2013 Cumulative Registered for Treatment till Dec 2013 Male 20,539 2,04,554 Female 19,644 1,89,932 Transsexual/Transgender 91 650 Children(<15 Years) 1622 21,866 Total 41,896 4,17,002 1 Estimated PLHIV 5 lakhs 2 Pre ART Registration 4,17,002 3 Ever on ART 2,36,801 4 Alive and on ART 1,58,177 5 Number of women on treatment for Prevention Parent to Child Transmission (PPTCT) 2866 6 Lost to follow up 30,480
Description For CLHA (Children living with HIV/AIDS) double nutrition under ICDS (Integrated Child Development Scheme) and foster care under ICPS (Integrated Child Protection Scheme)for children aimed at improving the quality of life of PLHIV, Most of the PLHIVs are from below poverty line and need social support at district level. Government of A.P. with the help of various line departments piloted initiatives to mitigate the economic impact of HIV among households of PLHIV. In addition to the medical services, the PLHAs are also benefited by State sponsored Social Welfare schemes like monetary aid in the form of pensions, concessional bus passes, subsidized commodities, preference in loans, etc. PLHIV on Anti retroviral Therapy are entitled for pension every month upon successful completion of 6 months of ART medication continuously. An amount of Rs.200/- per month towards this pension is funded from AP State Government fund from District Rural Development Authority (DRDA). 38,915 beneficiaries on ART are availing pension cards actively in the State till date. Also to mention every month about 11,010 women are utilizing widow pensions funded by State Govt. The State Govt. in close coordination with APSRTC has sponsored 50% concessional bus passes for PLHIV to promote adherence and better uptake of ART services. A total of 64,989 PLHIVs are currently availing concessional bus passes with 35,000 passes more being added to the beneficiaries shortly. APSACS lead the initiative of Convergence and Advocacy with District Administration, which also aided many PLHAs to avail social benefits and services like loans, widow pensions, 'Anthyodaya' Anna yojana cards etc
Lessons Learned Mainstreaming HIV Care towards convergence with regular Health Dept. assisted in reduction of discrimination among service providers. Social protection and benefit schemes for PLHIV families to subsidized food, education and health care motivated more PLHIV to reach out. Travel Concessions & pensions for those on ART improved access to treatment, promote adherence and better nutrition. In the State of AP political commitment to extend continued social protection schemes to PLHIV communities alongside psycho-social support could contribute significantly to improve their quality of life.
Conclusion In the context of a developing nation, it is crucial to ensure continuity of entitlements without the notion of 'burden'. Promoting corporate social responsibility could be an alternative support mechanism to ensure sustainable service provision. Collaboration with other Government departments, NGOs may enable a nondiscriminatory environment for PLHIV in accessing social protection schemes apart from improving coverage and service uptake.