Project Development Objectives:

The two key project objectives were to reduce the rate of growth of HIV infection in India and strengthen India's capacity to respond to HIV/AIDS.

Target Group

• Groups at high-risk of contracting HIV: This included sex workers (SWs), truck drivers, migrant laborers, men who have sex with men (MSM) and injecting drug users (IDUs).
• People living with HIV and AIDS (PLWHA). 
• The general community: Mass media campaigns on HIV awareness, enhanced safety of blood products, treatment of Sexually Transmitted Infections (STI), voluntary counseling and testing services were targeted to benefit all members of the community.
• Tribal population: Locally appropriate community education programs, training and services were included in states with large tribal populations.

The program shifted its focus from merely raising awarness on HIV/AIDS to changing behaviour through targeted interventions particularly for groups at high risk

Project Components

• Deliver cost-effective interventions against HIV/AIDS through
     i. targeted interventions for groups at high risk;
     ii. preventive interventions for the general community; and
     iii. low-cost AIDS care.
• Strengthen capacity through:
     i. institutional capacity strengthening; and
     ii. inter-sectoral collaboration.

In addition, the project supported five key policy and institutional reforms.

They were as follows:

• Shifting the focus of the program from merely raising awareness to changing behavior through targeted interventions, particularly for groups at high-risk of contracting and transmitting HIV;
• Decentralizing service delivery to the states and municipalities, and developing a new facilitating role for NACO;
• Protecting human rights by encouraging voluntary counseling and testing, and discouraging mandatory testing;
• Supporting structured and evidence-based annual reviews and ongoing operational research;
• Encouraging management reforms within state-level AIDS Control Societies (SACS); and
• Improving drug procurement practices.

Achievements

Service delivery was decentralized to states and municipalities

The Bank's contribution to AIDS control programming in India increased substantially between NACP I and II, from about US$ 83.6 million to US$ 190 million. New components were added, such Targeted (TI), and care and support. Moreover, funding towards strategic planning, policy development, intersectoral collaboration and program management increased significantly, while components such as blood safety, which comprised almost half of the program during NACP 1, constituted only about 20 percent of the program during NACP II.

Sustained efforts over the past two decades have also yielded many benefits. Recent data suggests there are signs of a decline in HIV prevalence among sex workers in areas where focused interventions have been implemented, particularly in the southern states although overall prevalence levels among this group continues to be high. Data also indicate that there is a slow decrease in HIV prevalence among the general population in southern states. Although more analysis is required, this probably means that the number of people becoming newly infected with HIV is decreasing. This decrease is more perceptible in states such as Tamil Nadu where the intensity of HIV prevention efforts has been high.

The Government of India estimates that in 2006, about 2.45 million Indians were living with HIV with an adult prevalence rate of 0.41%. State Aids Control Societies (SACS) have been established in all states and in three major municipalities (Ahmedabad, Chennai and Mumbai).

About 35-45 percent of female sex workers, 46 percent of Injecting Drug Users (IDU), and only six percent of Men Who Have Sex With Men (MSM) and Male Sex Workers (MSW) in project areas have been reached through some 1088 targeted interventions. NACP II had planned to cover 80 percent of the high-risk population. However, it has now been realized that the numbers to be covered are far larger than had been envisaged.