The overall image of the HIV and TB epidemic
Every first of December is World AIDS Day that is significant to the whole world to campaign for constructing the new and precise understanding of AIDS. There are three mutual goals, which are no new infections, no AIDS-related deaths and no discriminations, that lead to the achievement of ending AIDS in 2030.
The incidence of the global HIV/AIDS epidemic
According to the report from The Joint United Nations Programme on HIV/AIDS (UNAIDS), there are, in 2016, 36.7 million people who are cumulative infections, while 2.1 million are new infections and 1.1 million died from AIDS. In 2015, it was expected that there are up to 15.8 million, which rose from 7.5 in 2010, who could receive the Pre-Exposure Prophylaxis (PrEP).
The Epidemic of HIV or AIDS in Thailand
2017- 2021
According to the forecast of amounts in HIV infection and AIDS patients, there are 426,999 HIV infection,16,122 AIDS-related Deaths and 6,304 new infections in 2016. The Department of Disease Control, affiliated with Ministry of Public Health, which is the fundamental department that designs policies and measures to reinforce organizations, to prevent and to solve AIDS problems. The operation, conforming to Ending AIDS in the national strategy 2017- 2021, harmonizes with the United Nations (UN) commitment, Sustainable Development Goals (SDG) and also Political Declaration on HIV 2016 to cease the transmission of HIV.
Reference : World AIDS Day Factsheet 1 December 2016
Measures for Ending Aids
1) Encouraging people to know their statuses and take the treatment from the very beginning by employing the integration of preventions and treatments under the concept “Treatment as Prevention” and RRTTR. Highlighting on key population and presenting them the importance of PrEP, which is one of the solutions to prevent AIDS, and consequently provide them intensive services. Inducing them to take antiretroviral medicine right after they realize that they are HIV-positive without waiting to see the decrease of CD4.
2) Strengthening the management and altogether better steadily the perceptions/images of condoms in order to reinforce people to use condoms and lubricants more often as their benefits prevent people from various health problems.
3) Improving the standard of treatments for HIV infected people or AIDS patients or STIs and expanding these treatments to cover many parts of Thailand with enhancing Disease Specific Certificate; DSC HIV/STI so that the treatments are qualified and the spread of HIV will be reduced.
4) Extending the implementation and encouraging the government sectors to demonstrate the operation following the national guidelines on HIV/AIDS in workplaces under the idea “Treat Care, there’s no more AIDS” Setting a goal that at least 120 organizations would participate the operation within 2017 and also that the whole/people are aware of Human Rights, as well as have no bias regarding AIDS.
5) Campaigning for improving the understanding of HIV or STIs on any important days, for instance, World AIDS Day, Valentine’s Day, Zero Discrimination Day and Voluntary Counselling and Testing Day, Voluntary Counselling and Testing Day so that people realize the precise prevention as well as have positive attitudes (no biases, no discriminations) towards HIV infections and AIDS patients.
Strategy No. 1
Result
1.1 95% of key population receive/reach the effective/efficient service.
Strategy No.2
Improving the quality and integrating the effective prevention to be more intensive as well as sustainable.
Results
2.1 Zero children are born with HIV.
2.2 People are aware of it and behave cautiously.
2.3 the HIV prevention is efficient and integrated with the plan/system.
Strategy No.3
Developing and accelerating social treatment and support to be qualified in every aspect and sustainable.
Results
3.1 The infections know their statuses (95%), treat (95%) and take medicine to suppress their Viral Load (VL) (95%).
3.2 75% of the infections reach the social services.
3.3 The AIDS-related deaths reduce 75%.
3.4 Healthcare, society and community are in the engagement./relation.
Strategy No.4
Altering perceptions and understanding. Strengthening the potential of the individual, families, communities and the Human Rights Monitoring Mechanisms in order to decrease the stigma and discriminations relating to HIV and gender.
Results
4.1 People understand HIV, Human Rights andg gender.
4.2 The organization sets up policies and operations which better the understanding and reduce discriminations.
4.3 Both infections and affected populations are aware of their own values.
4.4 Every province has the Human Rights Monitoring Mechanisms.
Strategy No.5
Increasing the responsibilities of investments and potential of management in every sector from the international, the national, the provincial to the local.
Results
5.1 The rise of the proportion of international and domestic budget which supports AIDS, particularly the supportive budget to communities and non-governmental organizations.
5.2 Non-government and community organizations exceed the service standard, determined by each community.
5.3 Every province regulates plans, referring to the standard.
Strategy No.6
Results
6.1 The percentage of agencies which use the empirical information to arrange or operate
6.2 The amount number research that benefit the adjustment of working processes
The fundamental strategy to end AIDS
RRTTR is a framework which is a part of services that is developed as well as designed the project, namely “Stop TB and AIDS through RRTTR” or STAR and it is approved and receives the grant from The GLOBAL FUND TO FIGHT AIDS, TUBERCULOSIS AND MALARIA; GFATM from New Funding Model (NFM) round.
RRTTR, as in STAR, is identified to be a guideline to enhance the efficiency of the operation and accelerated/fast services that increase the access of services as following below,
38 covered provinces where are at risk of AIDS and TB. Using the strategy to reduce the epidemic of diseases, the morbidity and mortality from AIDS and TB. Additionally, civil societies under the regulation of Raks Thai which is in charge of 25 provinces simultaneously cooperate to create the integrated treatments and preventions.
Service provided for KPs for HIV and TB. Strengthening the prevention based in communities so that outreach populations and migrants, who are not covered in the national health insurance scheme, are able to get the HIV and TB services.
Amending the linkage of the national disease information by developing an information system to monitor the diseases as well as to check evaluations of HIV and TB, along with the coherence of TB information system and lastly finding new methods/techniques/technology to diagnose faster and to better the medications.
Meeting target groups
Recruiting them to take the services
Encouraging them to take the services
Activities
Gathering people and mapping the health facilities to formulate the strategies to recruit target groups into the system.
Outreach approach with Peer-led intervention
Approaching target groups, providing them information and creating the positive vibe so that they want to access the service.
Material Supporting
Preventing from diseases, for example, distributing hygiene condoms, needles or syringes.
Building service network in each community. For example, pharmacy, private clinic and Sub-district Health Promoting Hospital
Public communication
Sharing the correct and appropriate understanding of HIV or TB in order to generate the awareness.
Influencing them to take the services
Transferring the services
Activities
Setting mobile clinic to screen those who have STD or TB and suggesting target groups to take the testings willingly.
Transferring them to health facilities e.g. hospitals and HIV testing centers in communities.
Recruit partners
Recruiting their partners to get the services.
Same Day Result Testing
Friendly service
Activities
Same Day Result diagnosis (SDR) at hospitals, mobile clinics or services set by private organizations/NGOs (e.g. HTC) in target groups’ meeting points.
Cooperation of hospitals and outside that send/transfer infections to get the right services.
Getting the treatment early
Getting the right and appropriate service
Friendly service
Activities
Receiving the medication e.g. antiretroviral medicine and anti-tuberculosis medicine
Providing AIDS service continually ; checking CD4 counts, Viral Load and Genotypes
Retaining those who already took medicine and did not take at all.
Protecting and checking regularly.
Activities
Retaining in care, particularly before, during and after taking medicines.
(Adherence) Observing drug allergy
Shifting Task
Monitoring Drug resistance