Drug Overdose Prevention during COVID-19
Opportunities and Challenges in Manipur
COVID-19 has turned the world upside down in a very short period. The COVID-19 pandemic is marked as a time when the state of Manipur faced long-standing trouble of drug overdose resulting in increased deaths. I-TECH India, in coordination with Social Action and Service Organisation (SASO), successfully supported the drug overdose backup response units in providing services across the state.
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Improving access to services to Children Living with HIV
Experience from North East (India)
An estimated number of 79,000 children are living with HIV (CLHIV) in India1, which is 3.4% of the total PLHIV (people living with HIV) estimates in the country. Around 3,128 children are living with HIV in the states of Manipur, Mizoram and Nagaland in Northeast India where I-TECH India started working in the year 2017.
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Providing a comprehensive package of HIV services to prisoners
Though HIV prevention services work well in prison settings, HIV treatment initiation and monitoring remains a challenge in the absence of medical officer and lack of sufficient security personnel to support mobilisation of PLHIV to ART Centre. I-TECH India’s prison intervention in Mizoram has successfully demonstrated models delivering services from ART initiation to VL testing and a post release linkage support for retention and viral suppression.
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Streamlining and Strengthening HIV Interventions In Camping Centres
The state of Mizoram has the highest HIV prevalence (2.32%) in the country concentrated among IDU population. Since 2015, I-TECH India in partnership with the camping sites run by NGOs implements the HIV prevention and treatment interventions for IDU population in Mizoram. As of June 2021, more than 500 IDUs living with HIV are provided regular ART refills and need-based services at the 5 camping sites in 4 districts in Mizoram.
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ARTMitr – an Integrated Voice Response System
ARTMitr, an Integrated Voice Response system, was launched in Mumbai during the first wave of COVID-19 pandemic in 2020 to reach out to people living with HIV who missed their appointments in the stringent lockdown period. The implementation of the ARTMitr platform averted a potential crisis of treatment interruption by supporting ART delivery through decentralised sites.
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Improved HIV services through Community ART Refill Groups
The Differentiated Service Delivery Models (DSDM) tailor HIV-related services to the needs and preferences of different homogeneous groups of People Living with HIV (PLHIV). One of the successfully implemented DSDM in Nagaland is the Community Antiretroviral Refill Group (CARG) started in 2020. This model addresses the treatment adherence issues related to distance, transportation and financial constraints, and provides ART refills and psycho-social support to its members resulting in improved treatment adherence and retention in HIV care.
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Camp model for Viral Load testing in North East India
The ‘camp- based Viral Load sample collection model’ was introduced by I-TECH India in partnership with the State AIDS Control Society (SACS) in Northeast. Under this model, PLHIV eligible and due for viral load testing were mobilized for sample collection through community outreach at specified sites, outside the ART centers. This also aided in the transition of PLHIV to the recently introduced Dolutegravir (DTG) based regimens in the national programme.
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First Transgender Wellness Centre in North East India
India now has its first ever Health Clinic for the Transgender people of the country. Located in Imphal, Manipur, this Transgender Health and Wellness Centre aims to provide Health, Wellness, Gender affirmation support and Welfare Services along with Capacity Building and Skills Building for Empowerment of the Transgender Communities through Public Private Partnership. The Transgender Health and Wellness Centre is functionally managed by I-TECH India and Maruploi Foundation and is expected to cater to specific needs of transgender population.
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Health on Bike – Reaching the Unreached
Continuous efforts by I-TECH India have now made it possible to reach the PLHIV living in unreached and hard to reach areas of India’s easternmost district – Noklak. The I-TECH India team diligently worked to provide quality HIV care and treatment services such as ART initiation and delivery, to the People with Injecting Drugs (PWIDs) of Noklak. With support from Nagaland State AIDS Control Society, a cooperative model is adopted where motorbikes are used for outreach. This innovation is expected to provide HIV prevention and harm reduction services to the difficult to reach People Who Inject Drugs in Noklak.
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I-TECH India – Response to COVID-19
COVID-19 lockdown hit the HIV/AIDS patients hard since it meant that they could not receive the periodic medical care and treatment which is necessary to keep them healthy and well. The sudden discontinuation of transportation services to curb the COVID -19 pandemic left most of these PLHIV anxious about their monthly drug refill status since these drugs were not available at district level.
Responding to the COVID-19 situation, I-TECH India supported the State AIDS Control Societies in the states of Maharashtra, Manipur, Nagaland and Mizoram, to plan the ART drug delivery to rural and other inaccessible areas. In Maharashtra, I-TECH India telephonically reached out to the PLHIVs across the state through an IVRS menu specially designed for this situation.
Click here for some success stories of I-TECH India’s response during COVID-19.
Implementation of ‘Treat All’ policy
I-TECH India supported the implementation of the new “Treat All” policy launched by Government of India in 2017 for treating all PLHIV’s irrespective of clinical criteria. I-TECH India launched the initiative in Maharashtra and identified 13,937 potential pre-ART clients who were still alive and eligible to start ART after intensive review of ART patient records. After patient identification was done, efforts were made to contact these clients by telephone or home visits, so that they could return to clinics to start their treatment. A total of nearly 5,000 clients were brought back to ART centres and were initiated on ART under this intervention.
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Strengthening Healthcare through Centers of Excellence
I-TECH India provides technical assistance to establish Centres of Excellence (CoE) and Paediatric Centres of Excellence (pCoE) at eminent tertiary medical institutions to model high-quality comprehensive patient care for persons living with HIV; train and mentor staff from ART clinic sites; and undertake operational and clinical research.
I-TECH India provides an array of capacity-building support to the 17 CoE (including 7 pCoE) through distance learning seminars, continuing medical education, site visits focused on technical assistance and sharing of references.