According to National AIDS Control Organization 2007 estimates ,out of an estimated 2.31 million people with HIV and AIDS in India, women constitutes 39% and children below 15 years stands at 7.8%
Out of the 70,000 children below 15 years with HIV in India, 21,000 are infected every year through parent to child transmission.
There are an increasing number of children dying with AIDS is a major concern in India.
In April 2004 ART programme was launched in 6 high prevalence states of India for HIV infected people. Realising the need for extending free ART to increasing number of Children living with HIV, the paediatric AIDS initiative was launched in 2006 .The main focus was to reduce the disparity between the number of children living with HIV and AIDS and the number of children receiving treatment.
However despite all the efforts by the government and civil society, sustainable access of CLHIV and families to ART centres is often limited due to several socio-economic and institutional barriers.
Stigma and the resultant discrimination permeating the social milieu at various levels : within the family, community ,institutions and the society at large.
Economic constraints caused by inadequate availability of financial resources in poor and child headed families resulting in ART taking a back seat.
Infrastructural issues related to location of the ART centres at a long distance, insufficient number of ART centres to cater a large population.
Unsatisfactory support from parents and care givers owing to procedural difficulties at ART centres.
Lack of awareness about Paediatric ART and HIV/AIDS since ART was primarily adult focussed and there has been lack of child focused information, education and communication on HIV/AIDS. Lack of coordination, collaboration and convergence between agencies, depts and related programmes.
Improved access to ART centres is key to fight against HIV/AIDS.It is important to design and implement intensive child-focused IEC separately targeting rural and urban population through an appropriate mix of media.It is also important to disseminate appropriate information on HIV and AIDS ,paediatric diagnosis and ART through mass media and other communication campaigns to impart correct knowledge and generate awareness across rural and urban areas.
It is also imperative to expand the treatment by decentralising ART services by increasing the number of ART centres close to small and medium towns with services like HIV testing, CD4 count and prognostic support. These should be set up at strategic locations to reduce the time taken and also the expenses involved in travelling long distances to reach these centres.
There should be direct referral of children from the counselling section to ART section to save them from the hassles of waiting at different counters. To further improve access, flexible timings should be introduced at ART centres to help parents and children avoid frequent absence from work and schools.
There is a need for improved coordination between AIDS control societies and district health depts. There is a need to strengthen operational facilities and comprehensive package of services under one roof. All key facilities should be brought under one roof to enhance accessibility and accountability.
Source: Policy Brief, International HIV/AIDS Alliance in India