Professional Documents
Culture Documents
Annexures
Annexures
Annexure 1 Baseline Assessment 334
Annexure 2 Quick Reference Steps In using a Maleand a Female Condom 337
Annexure 3 Referral Linkage Organogram 339
Annexure 4 Disinfection of Needles and Syringes with Bleach 340
Annexure 5 Hand Hygiene Checklist 341
Annexure 6 Guidelines for Disposal of Used Disposable Needles and Syringes 342
Annexure 7 Guidelines for Disinfection and Sterilization 343
Annexure 8 Situational Guide - Cleaning up a Blood Spill on the Floor 344
Annexure 9 Situational Guide - Care of the Body after Death of a PLHIV 346
Annexure 10 NACO PEP Policy: Procedure to be followed after an Accidental Exposure to HIV
Infectious Fluid 347
Annexure 11 STI Syndrome Flowchart Management Urethral Discharge & Burning micturation 359
Annexure 12 STI Syndrome Flowchart Management of Scrotal swelling 360
Annexure 13 STI Syndrome Flowchart Management of Inguinal Bubo 361
Annexure 14 STI Syndrome Flowchart Management of Genital Ulcers 362
Annexure 15 STI Syndrome Flowchart Management of Vaginal Discharge 363
Annexure 16 STI Syndrome Flowchart Management of Lower Abdominal pain in females 364
Annexure 17 STI Syndrome Flowchart Management of Oral & Anal STIs 365
Annexure 18 STI Syndrome Flowchart Management of Molluscum and Ectoparastic infestation 367
Annexure 19 STI Syndrome Flowchart-Management of Ophthalmic Neonatorum 370
Annexure 20 Guide to Common Symptoms and Possible Aetiologies 370
Annexure 21 What a Nurse needs to know about Dementia and Delirium 372
Annexure 22 Comprehensive laboratory evaluation in HIV/AIDS 374
Annexure 23(a) Diagnosis of HIV infection among infants and children below 18 months 375
Annexure 23(b) Specimen Collection (by heel prick) and handling procedure
for HIV DNA PCR testing by Dried Blood Spot (DBS) sample collection 377
Annexure 24 Monitoring and follow up patients on ART: Recommendations in the National
Programme 382
Annexure 25 4 Prong NACO PPTCT Strategy 384
Annexure 26 PPTCT True or False Statements and Answers 388
Annexure 27 PPTCT: Three Safe Infant Feeding Options Some Important Points
You Could Keep In Mind When Counselling Mothers On Feeding Options 389
Annexure 28 Replacement Feeding Checklist 391
Annexure 29 Questions and Issues that must be assessed by the Nurse to Aid In
Preparing the Child And Family For ARV 392
Annexure 30 Ways to Promote ART Adherence in Children 393
Annexure 31 WHO Growth Monitoring Charts 394
Annexure 32 Dosing Schedule For Infants and children below 18 months 396
Annexure 33 Antiretroviral Therapy For TB patients 397
Annexure 34 Assuming the quality /amount of PTH 399
Annexure 35 Music Therapy 400
Annexure 36 National AIDS Control Organization (Phase III) 402
Annexure 37 List Of State AIDS Control Societies (SACs) 403
Annexure 38 List Of ART Centres 406
Annexure 39 List Of Community Care Centres (CCCs) 413
Annexure 40 Ice Breakers & Energizers 435
Annexure 41 Role Of Nurse at ART & CCCs 438
Annexure 42 Patient Treatment CardART White Card 439
Annexure 43 Counselling Checklists 448
BASELINE ASSESSMENT:
Focus on information that is significant to HIV care. Approach the assessment in a systematic, organized
manner using the information below as a guide.
Baseline assessment: Presented below is a checklist , one could use when assessing a patient
Focus on information that is significant to HIV care. Approach the assessment in a systematic, organized
manner using the information below as a guide.
I. FACTOR DETAILS
Name (Optional)
Age
Gender
Address (Optional)
Contact Details
Care Givers Contact Details
Entry Point (Services referring the patient for HIV care) :
(ICTC/ RNTCP/ Outpatient/ Inpatient/ Pediatric/ PPTCT
Centre/ STI Clinic/ ART Centre/ IDU outreach/
Sex Worker Outreach/ PLHIV Network/ MSM/
Private Practitioner/Self Referred
Employed (Y/N)
Occupation
For Pediatric Patients (under 15 yrs.):
Staying with (Own Family/ In a centre -
No family contact/In a centre - family
contact
Guardian /Caregivers Education
Date of admission or clinic visit
Do Dont
1. 2.
OPEN END (Outer ring): Covers the HOW TO HOLD THE POUCH: Hold
area around the opening of the vagina. inner ring between thumb and middle
INNER RING used for insertion. Helps finger. Put index finger on pouch
hold the pouch in place. between other two fingers.
3. 4.
HOW TO INSERT IT: Squeeze the MAKE SURE PLACEMENT IS
inner ring. Insert the pouch as far as CORRECT: The pouch should not be
possible into the vagina. Make sure the twisted. Outer ring should be outside
inner ring is past the public bone. the vagina.
Injecting drug users often do not have access to a steady supply of disposable syringes, and re-use/share
needles with other IDUs. The procedure below can be taught to them to minimize the risk of HIV transmission
under such circumstances. Remember, where available disposable, unshared needles are always the first
choice.
Procedure:
It will probably take 5-10 minutes to follow the recommended procedures for
cleaning and disinfecting.
Fill the needle and syringe completely with clean water
Shake vigorously for 30 seconds, and shoot out the water into the sink or
onto the ground
Repeat the process
Then, completely fill the needle and syringe (to the top) with full-strength (not
diluted) liquid household bleach several times.
Keep the bleach for at least 30 seconds
Shoot out the bleach and repeat
Rinse the syringe and needle by completely filling several times with CLEAN
water.
Remember:
Cleaning and disinfecting should be done at two points of timeonce
immediately after use and again just before re-use of needles and syringes.
ALL used solutions should be disposed of (e.g. by placing in a waste container
or pouring down a sink or toilet or on the ground). DO NOT REUSE.
Every time the cleansing process is repeated, the more likely HIV and other
blood borne pathogens will be inactivated
Taking the syringe apart by removing the plunger may also improve the
cleaning/disinfection of parts that might be hard to reach (e.g., behind the
plunger).
Although it is important to follow all steps in the bleach disinfection procedures
to ensure maximum effectiveness, drug users who indicate they may be
unable to do so should be encouraged to perform as much of the process
as possible.
The more steps done, the more effective the disinfection process is likely to
be in reducing risk of HIV transmission.
Procedure Done
Keeping the above points in mind, think about what resources are required for regular efficient hand
hygiene and make a mental note to check if these are available at your centre.
Sever needles from disposable syringe immediately after administering injection using a needle
cutter/hub-cutter that removes the needle from disposable syringes or cuts plastic hub of
syringe from AD syringes
The cut needles get collected in the puncture proof container of the needle cutter/hub-cutter.
The container should contain an appropriate disinfectant and the cut needles should be completely
immersed in the disinfectant
Segregate and store syringes and unbroken (but discarded) vials in a red bag or container.
Send the collected materials to the common bio-medical waste treatment facilities. If such
facilities do not exist, then go to the next step.
Treat the collected material in an autoclave. If this is unavailable, treat the waste in 1%
hypochlorite solution or boil in water for at least 10 minutes. It shall be ensured that these
treatments ensure disinfection
Dispose the autoclaved waste as follows: (i) Dispose the needles and broken vials in a pit /
tank, (ii) Send the syringes and unbroken vials for recycling or landfill.
Wash the containers properly for reuse
Make a proper record of generation, treatment and disposal of waste
Copyright 1996 The Association for Professionals in Infection Control and Epidemiology, Inc. (APIC) 1016
Sixteenth Street NW, Sixth Floor, Washington, DC 20036
202-296-2742 Fax 202-296-5645 E-mail APICinfo@apic.org
Instruct the hospital worker or cleaner to wear appropriate personal protective equipment: plastic
apron, shoes and disposable gloves.
Put a towel / gauze / cotton over the spill area to cover it completely.
Pour hypochlorite solution 10% over the covered cloth to soak it completely.
Leave the solution on the cloth for another 30 minutes without disturbance.
Carefully lift the cloth from the floor, mopping the whole spill onto the cloth and dispose into the
yellow bin.
Using a routine mop and soap water solution swipe the area and wash the mop and hang it out to
dry.
Remove gloves and dispose into red bin.
Wash hands under running water with soap and dry hands.
HIV can survive in cadavers for a considerable amount of time (up to 16 days after death if stored at 2C.
Viable HIV has also been isolated from bone fragments, spleen, brain, bone marrow, and lymph nodes at
autopsy 6 days post-mortem.
Do Dont
Protect self by using PPE and avoiding Give bath to the dead body.
injuries Embalming bodies, especially when infected
Gloves, especially if the body has many with hepatitis B, hepatitis C, HIV or rabies as
wounds. it involves the extraction of infected material
Wear other PPE only if large quantities of from body as well as further exposure of
splashes of blood are anticipated. infected tissues and cant be guaranteed to
Bodies that need to be handled especially eliminate the risk of infection from the body.
directly from emergency rooms or after (If absolutely essential, use all PPE)
resuscitation procedures may contain
needles or other sharps. Care should
be taken to avoid needle stick and
sharps injuries.
Enclose the body in double plastic
sheet/bag to avoid contamination and
spread of infection
Remove PPE after the procedure
Discard PPE into linen bin for laundering or
dispose appropriately.
Wash hands after removing PPE.
A shower should be taken before leaving
the room.
Disinfect the environment and any other place
or item that is contaminated with body
secretions with 1% hypochlorite solution.
Educate relatives of deceased about
a. Body to be kept enclosed in the double
plastic sheet/bag with seal.
b. Need for burial or cremation as early
as possible,
c. Sealing the coffin is not required.
Disinfecting if needed and then washing
patients clothing, bed linen, and other
personal items.
Do Do Not
Two main factors determine the risk of infection: the nature of exposure and the status of the source patient.
Categories of exposure
The wearing of gloves during any of these accidents constitutes a protective factor.
Note: In case of an AEB with material such as discarded sharps/needles, contaminated for over 48 hours,
the risk of infection becomes negligible for HIV, but still remains significant for HBV. HBV survives longer
than HIV outside the body.
HIV negative Source is not HIV infected but consider HBV and HCV
Low risk HIV positive and clinically asymptomatic
High risk HIV positive and clinically symptomatic (see WHO clinical staging)
Unknown Status of the patient is unknown, and neither the patient nor his/her blood
is available for testing (e.g. injury during medical waste management the
source patient might be unknown). The risk assessment will be based only
upon the exposure (HIV prevalence in the locality can be considered).
HIV infection is not detected during the primary infection period by routine-use HIV tests. During the
window period , which lasts for approximately 6 weeks, the antibody level is still too low for detection
but infected persons can still have a high viral load. This implies that a positive HIV test result can help
in taking the decision to start PEP, but a negative test result does not exclude HIV infection. In countries
or population groups with a high HIV prevalence, a higher proportion of HIV-infected individuals are found
in the window period. In these situations, a negative result has even less value for decision-making on PEP.
Key information to provide informed consent to the client after occupational exposure
The risk of acquiring HIV infection from Ask client for understanding of HIV
the specific exposure transmission risk after exposure
The risk of getting HIV infection from a
person known to be HIV positive is estimated
to be
Sharps injury: 3 in 1000 exposures (0.3%)
Mucous membrane splash: 1 in 1000
exposures (0.1%)
the risk is increased with large exposure e.g.
needle-stick from hollow bore needles with
visible blood, from artery or vein and from
source patients with high viral load
(usually very sick persons with OIs)
What is known about PEP efficacy Ask Clients understanding of PEP
PEP is provided to prevent potential
transmission of HIV
PEP is not 100% effective and should be
given within 72 hours (ideally as soon as
possible, if eligible).
Balance risk and benefits of PEP: PEP may
prevent HIV transmission, versus possible
risk of side effects
Information about clients risk of HIV Clients possibility of prior HIV infection
infection based upon a risk assessment should be assessed
(if s/he has not had a recent HIV test) Counsel for HIV testing and follow-up
The importance of being tested and psychosocial support where possible rapid
receiving appropriate post-test counselling testing should be used based on national
(although HIV testing can be delayed testing guidelines
if needed) Inform if the Baseline HIV test is positive,
PEP medicines will be discontinued then the PEP will be discontinued
if their initial (baseline) HIV test is positive Arrange referral to ART centres for
assessment if found HIV positive
Common side effects that may be Discuss possible side effects of the PEP
experienced medicines e.g. Nausea, Fatigue, Headache
(depending on which drugs given)
Side effects often improve over time. It is
often minor and do not need specialised
supervision.
Symptomatic relief can also be given by
using other drugs
They can stop at any time but will Animal studies suggest that taking less than
not get the benefit of PEP if the source 4 weeks of PEP does not work
is HIV positive If client decides to stop at any time, s/he
needs to contact the physician before
stopping the medications
Arrange for follow-up visit and decide further
course of action/follow-up
Prevention during the PEP period e.g. After any AEB, the exposed person should
sexual intercourse and unplanned pregnancy not have unprotected sexual intercourse until
it is confirmed, 3 months after the exposure,
that s/he is not HIV infected.
It is also advised to avoid pregnancy.
Use of condoms is essential
If Client is pregnant she can still take The PEP drugs used are safe for pregnancy
PEP during pregnancy If the client gets HIV during the pregnancy
due to the exposure, the baby will have
some risk of becoming HIV infected
Safety of PEP if the client is breastfeeding The PEP drugs used are safe during
breast-feeding
May consider stopping breastfeeding if
PEP is indicated.
Educate client on the possible signs and Signs and symptoms of early HIV sero-
symptoms of early HIV sero-conversion conversation: Fever, Rash, Oral Ulcers,
Pharyngitis, Malaise, Fatigue, Joint Pains,
Weight loss, Myalgia, headache
(similar to Flu-like symptoms)
Risk of acquiring Hepatitis B and C from Risk of Hepatitis B is 9-30% from a Needle
a specific exposure and availability of Stick Exposure the client can be given
prophylaxis for this vaccinations
Risk of Hepatitis is 1-10% after Needle Stick
Exposure there are no vaccinations for this.
* Provider should correct misconceptions at all times during the counselling sessions
Psychological support:
Many people will feel anxious after exposure. Every exposed person needs to be informed about the risks
and the measures that can be taken. This will help to relieve part of the anxiety, but some may require
further specialised psychological support.
Documentation on record is essential. Special leave from work should be considered for a period of time
e.g. 2 weeks (initially) then, as required based on assessment of the exposed persons mental state, side
effects and requirements.
Deciding on therapy
There are two types of regimens:
a) Basic regimen: 2-drug combination
b) Expanded regimen: 3-drug combination
The decision to initiate the type of regimen depends on the type of exposure and HIV serostatus of the
source person. See Table 6.
Mild Consider 2-drug PEP Start 2- drug PEP Usually no PEP or consider 2-drug PEP
Moderate Start 2-drug PEP Start 3-drug PEP Usually no PEP or consider 2-drug PEP
Severe Start 3-drug PEP Start 3-drug PEP Usually no PEP or consider 2-drug PEP
HIV testing of the source patient should not delay the decision about whether or not to start PEP. Start
2-drugs first if required, then send for consultation or refer.
In the case of a high risk exposure from a source patient who has been exposed to or is taking
Antiretroviral medications, consult an expert to choose the PEP regimen, as the risk of drug resistance
is high. Refer/consult expert physician. Start 2 drug regimens first.
* Fixed Dose Combination (FDC) are preferred, if available. Ritonavir requires refrigeration.
Preferred Alternative
More information on alternative schedules is available in the latest update USPHS guidelines issued 30
September 2005. (http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5409a1.htm) or www.who.int
Selection of the PEP regimen when the source patient is known to be on ART: The physician should
consider the comparative risk represented by the exposure and information about the exposure source,
including history of and response to antiretroviral therapy based on clinical response, CD4 cell counts, Viral
load measurements (if available), and current disease stage (WHO clinical staging and history). When the
source persons virus is known or suspected to be resistant to one or more of the drugs considered for the
PEP regimen, the selection of drugs to which the source persons virus is unlikely to be resistant is
recommended. Refer for expert opinion.
If this information is not immediately available, initiation of PEP, if indicated, should not be delayed.
Give the 2 drug (basic) regimen. Changes in the PEP regimen can be made after PEP has been started,
as appropriate. Re-evaluation of the exposed person should be considered within 72 hours Post-Exposure,
especially as additional information about the exposure or source person becomes available.
Nausea Take with food. If on AZT, reassure that this is common, usually self-limited.
Treat symptomatically.
Headache Give Paracetamol. Assess for Meningitis. If on AZT or EFV, reassure that
this is common and usually self-limited. If persists more than 2 weeks,
call for advice or refer.
Diarrhoea Hydrate. Follow diarrhoea guidelines. Reassure patient that if due to ARV,
this will improve in a few weeks. Follow up in 2 weeks. If not improved,
call for advice or refer.
Fatigue This commonly lasts 4 to 6 weeks especially when starting AZT. Give
sick leave from work. If severe or longer than this, call for advice or refer.
CNS side effects: This may be due to EFV. Take EFV at night before sleeping; counsel
Anxiety, nightmares, and support (usually lasts < 3 weeks). Initial difficult time can be managed
psychosis, depression with amitriptyline at bedtime.Call for advice or refer if severe depression
or suicidal tendencies or psychosis. (Stop EFV).
Blue /black nails Reassure. It is a non-threatening side effect, common with AZT
Rash If on EFV, assess carefully. Is it a dry or wet lesion? Call for advice.
If generalised or peeling, stop drugs and refer for expert opinion.
Fever Assess clinically for Hepatitis or if this could be Primary (acute) HIV
infection or other non-HIV related infections e.g. concurrent common cold.
Call for advice or refer.
HEPATITIS B
All health staff should be vaccinated against Hepatitis B. The vaccination for Hepatitis B consists of 3
doses: initial, 1 month, and 6 months. Sero-conversion after completing the full course is 99%.
HEPATITIS C
There is presently no prophylaxis available against hepatitis C. There is no evidence that Interferon,
pegalated or not, with or without Ribavirin is more effective when given at this time than when given
at the time of disease. Post-Exposure management for HCV is based on early identification of chronic
HCV disease and referral to a specialist for management.
*HIV, HBV and HCV testing of exposed staff within 8 days of an AEB is required (baseline serostatus).
Offer an HIV test in case of an AEB, as a positive HIV status may indicate the need to discontinue
PEP. The decision on whether to test for HIV or not should be based on informed consent of the exposed
person.
** Transaminases should be checked at week 2 and 4 to detect hepatitis in case the exposed person
contracted HBV from the AEB.
*** For persons started on AZT-containing PEP regimens
Clinical follow-up
In addition, in the weeks following an AEB, the exposed person must be monitored for the eventual
appearance of signs indicating an HIV seroconversion: Acute Fever Generalised Lymphadenopathy,
Cutaneous Eruption, Pharyngitis, non-specific Flu symptoms and Ulcers of the mouth or Genital area.
These symptoms appear in 50%-70% of individuals with an HIV primary (acute) infection and almost always
within 3 to 6 weeks after exposure. When a primary (acute) infection is suspected, referral to an ART centre
or for expert opinion should be arranged rapidly.
An exposed person should be advised to use precautions (e.g., avoid Blood or tissue Tonations, Breastfeeding,
Unprotected sexual relations or Pregnancy) to prevent secondary transmission, especially during the first
6-12 weeks following exposure. Condom use is essential.
Adherence and side effect counseling should be provided and reinforced at every follow-up visit. Psychological
support and mental health counseling is often required.
Step 6 Monitor and follow-up of HIV, HBV and HCV status 6 months
Causative Organisms
Syndrome Urethral discharge in Males
Neisseria Gonorrhoea
Chlamydia trachomatis
Trichomonas vaginalis
Treatment
As dual infection is common, the treatment for urethral discharge should adequately cover therapy for both gonorrhoea
and chlamydial infections.
Recommended regimen for uncomplicated gonorrhoea + chlamydia Uncomplicated infections indicate that the disease is
limited to the anogenital region (anterior urethritis and proctitis).
Tab. Cefixime 400 mg orally, single dose Plus
Tab Azithromycin 1 gram orally single dose under supervision
Ensure patient takes medication under your direct observation
Advise the client to return after 7 days of start of therapy
When symptoms persist after adequate treatment for gonorrhoea and chlamydia in the index client and partner(s), they
should be treated for Trichomonasvaginalis.If discharge or only dysuria persists after 7 days
Tab. Secnidazole 2 gm orally, single dose (to treat for T.vaginalis)
If the symptoms still persist
Refer to a higher centre as early as possible
Neisseria Gonorrhoea
Chlamydia trachomatis
Treatment:
Treat for both gonococcal & chlamydial infections Tab Cefixime 400mg orally BD for 7 days Plus
Cap Doxycycline 100mg BD for 14 days & refer to hihercentre as soon as possible since complicated
gonococcal infection needs parental & longer duration of treatment.
Sopportivetherapyto reduce pain (bed rest, scrotal elevation with T bandage and analgesics
Differential diagnosis( Non RTIs /STIs) Infections Causing Scrotal Swelling Tuberculosis,Filariasis,
Coliforms. Pseudomonas,Mumpsvirus infection.
NonInfectious causes:
Trauma, Hernia, Hydrocoel,Testicular torsion & Testicular tumors
Causative Organism
Bacteria Haemophilus ducreyi
Calymmatobacterium granulomatis
(Klebsiella granulomatis)
Chlamydia trachomatis
Laboratory investigations
Examination Diagnosis is on clinical grounds
History Look for
Swelling in inguinal region Localized enlargement of
which may be painful lymphnodes in groin which Differential diagnosis
Preceding history of genital may betender and fluctuant
ulcer or discharge Mycobacterium tuberculosis,
Inflammation of skin over filariasis
Sexual exposure of either the swelling
partner including high risk Any acute infection of skin of
Presence of multiple sinuses pubic area, genitals, buttocks,
practices like oro-genital sex Edema of genitals and
etc anus and lower limbs can also
lower limbs cause inguinal swelling.
Systemic symptoms like Presence of genital ulcer or
malaise, fever If malignancy or tuberculosis
urethral discharge, if present, is suspected refer to a higher
refer to respective flowchart centre for biopsy.
Note:
TREATMENT A bubo should never be incised and drained at the
Start Cap Doxycycline 100mg orally twice primary Designated STI Clinic, even if it is fluctuant,
dailyfor 21 days (To cover LGV) Plus as there is a high risk of fistula formation and
Tab Azithromycin 1gm orally single dose chronicity. If bubo becomes fluctuant always refer for
OR aspiration to a higher centre.
Tab Ciprofloxacin 500mg orally, twice daily In severe cases with vulval edema in females,
for 3 day to cover chancroid. surgical intervention in the form of vulvectomy
Refer to higher centre as early as possible. may be required for which they should be referred to
a higher centre.
Causative Organisms
Neisseria gonorrheae
Chlamydia trachomatis
Mycoplasma Gardnerella Anaerobic
bacteria(BacteroisSp, Gram positive cocci)
History Examination
Laboratory Investigations
Lower abdominal pain if available
General examination: Temperature, Pulse, Wet smear examination
Fever Blood pressure
Vaginal discharge Gram stain for gonorrhea
Per Speculum examination: vaginal/ cervical
Menstural irregularities Complete Blood count & ESR
discharge, congestion or ulcers
like heavy, irregular
Per abdominal examination: lower abdominal Urine microscopy for pus cell
vaginal bleeding
Dysmenorrhoea tenderness or guarding
Differential Diagnosis
Dyspareunia Pelvic examination: uterine/ adnexal Ectopic Pregnancy
Dysuria,tenesmus tenderness, cervical movement tenderness. Twisted Ovarian cyst
Low backache Note: A urine pregnancy test should be done Ovarian tumor
Contraceptive use like in all women suspected of having PID to Appendicitis
IUD rule out ectopic pregnancy. Abdominal tuberculosis
History of Examination
Unprotected oral sex Look for Laboratory
with Oral ulceration, redness, pharyngeal Investigations
pharyngitis. inflammation RPR/VDRL for syphilis
Unprotected anal sex Genital or anorectal ulcers single or Gram stain examination
with anal discharge or multiple of rectal swab will
tenesmus, diarrhea, Presence of vesicles show gram negative
blood in stool, Rectal pus intracellular diplococcic
abdominal cramping, Any other STI syndrome in case of gonorrhea.
nausea, bloating (Do proctoscopy for rectal
examination if available)
Tab. Azithromycin 1 gm
Follow flowchart Follow flowchart Tab. Cefixime 400 mg
urethral discharge genital ulcer (Follow urethral discharge syndrome flowchart)
syndrome and treat syndrome Anti-diarrheal medicines as needed
accordingly &
Refer to higher facility
Causative Organism
Virus: Human Papilloma Virus (HPV)
Clinical Features
Single or multiple soft, painless, pink in colour, cauliflower like growths which appear around the
anus, vulvo-vaginal area, penis, urethra and peri-neum.
Warts could appear in other forms such as papules which may be keratinized.
Diagnosis
Presumptive diagnosis by history of exposure followed by signs and symptoms.
Differential diagnosis
i. Condyloma lata of syphilis
ii. Moluscum contagiousm
Treatment
Recommended regimens:
Penile and Perianal warts
20% Podophyllin in compound tincture of benzoin applied to the warts, while carefully
protecting the surrounding area with Vaseline, to be washed after 3 hours. It should not be used
on extensive areas per session.
Treatment should be repeated weekly till the lesions resolve completely.
Causative Organism
Pox virus
Clinical features
Multiple, smooth, glistening, globular papules of carrying size from a
pinhead to a split pea can appear anywhere on the body. Sexually
transmitted lesions on or around genitals can be seen. The lesions are not
painful except when secondary infection sets in. When the lesions are
squeezed, a cheesy material comes out.
Diagnosis
Diagnosis is based on the above clinical features.
Treatment
Individual lesions usually regress without treatment in 9-12 months.
Each lesion should be thoroughly opened with a fine needle or scalpel. The contents should be exposed
and the inner wall touched with 25% phenol solution or 30% trichloracetic acid.
Pediculosis pubis
Causative Organism
Lice-Phthirus pubis
Clinical features
There may be small red papules with a tiny central clot caused by lice irritation.
General or local urticaria with skin thickening may or may not be present.
Treatment
Recommended regimen:
Permethrin 1% crme rinse applied to affected areas and wash off after 10 minutes
Special instructions
Retreatment is indicated after 7 days if lice are found or eggs observed at the hair-skin junction.
Clothing or bed linen that may have been contaminated by the client should be washed and well dried
or dry cleaned.
Sexual partner must also be treated along the same lines.
Scabies
Causative Organism
Mite-Sarcoptes Scabiei
Clinical features
Severe pruritis (itching) is experienced by the client which becomes worse at night.
Other members of family also affected (apart from sexual transmission to the partner,
other members may get infected through contact with infected clothes, linen or
towels).
Complications
Eczematization with or without secondary infection
Urticaria
Glomerulonephritis
Contact dermatitis to antiscabetic drug
Diagnosis
The burrow is the diagnostic sign. It can be seen as a slightly elevated grayish dotted line in the skin, best seen in the
soft part of the skin.
Treatment
Recommended regimens:
Permethrin cream (5%) applied to all areas of the body from the neck down and washed off after 8 to 14 hours
Benzyl benzoate 25% lotion, to be applied all over the body, below the neck, after a bath, for two consecutive nights.
Client should
bathe in the morning, and have a change of clothing. Bed linen is to be disinfected.
Special instructions
Clothing or bed linen that have been used by the client should be thoroughly washed and well dried or dry cleaned.
Sexual partner must also be treated along the same lines at the same time.
Partner management
Timely partner management serves following purpose:
Prevention of re-infection
Prevention of transmission from infected partners and
Help in detection of asymptomatic individuals, who do not seek treatment.
Critical issues on partner management
Confidentiality Partners should be assured of confidentiality. Many times partners do not seek services, as they
perceive confidentiality as a serious problem. Respecting dignity of client and ensuring confidentiality will promote
partner management.
Voluntary reporting Providers must not impose any pre-conditions giving treatment to the index client. Providers may
need to counsel client several times to emphasize the importance of client initiated referral of the partners.
Client initiated partner management Providers should understand that because of prevailing gender inequalities,
women may not be in a position always to communicate to their partners regarding need for partner management. Such
client imitated partner management may not work in some relationships and may also put women at the risk of
violence. Hence alternative approaches should be considered in such situations.
Availability of services RTI/STI diagnostic and treatment services should be available to all partners. This may mean
finding ways to avoid long waiting times. This is important because many asymptomatic partners are reluctant to wait
or pay for services when they feel healthy.
Approaches for partner management
Date: There are two approaches to partner management:
Please attend the following centers along i. Referral by index client
with the card In this approach, index client informs the partner/s of possible infection.
Stamp of the Facility This appears to be a feasible approach, because it does not involve extra
Timings: personnel, is inexpensive and does not require any identification of partners.
A partner notification card with relevant diagnostic code should be given
Diagnostic Code:
to each index client where partner management is indicated. This approach
may also include use of client initiated therapy for all contacts.
Inadequate Anorexia
Oral Intake Nauseous and vomiting
Dysphagia
Odynophagia
Inadequate access to food
Altered nutrition
Source: Adapted from Kirton, C. Talotto, D. & Zwolski, K. (2001) Handbook of HIV/AIDS Nursing
Dementia
Definition:
An organic mental disorder characterised by loss of intellectual abilities of sufficient severity to interfere with
social or occupational functioning. HIV-associated dementia is known as AIDS Dementia Complex (ADC)
Patients may present with ambulation/gait problems, mania, panic, psychosis, withdrawal or anxiety. Dementia
is progressive with a variable course. Patients with HIV-related dementia are often acutely aware of their
deterioration, which may lead to an adjustment disorder with profound fear, anxiety or depression.
Aetiology
HIV associated dementia HIV directly invades the brain tissue shortly after infection-was the most frequently
seen single neurologic complication of AIDS before the HAART era in the U.S.
Drug withdrawal
Pain
Delirium
Definition:
Characterized by disturbance of consciousness and a change in cognition that develops over a period of
time and is caused by the direct physiologic consequences of a medical condition. Delirium is the most
common neuron-psychiatric complication in hospitalised AIDS patients.
Risk factors for Delirium in AIDS patients:
Advanced stage of immuno-suppression
History of OIs, especially affecting CNS
Substance use
Head or brain injury
Episodes of delirium or dementia
Assessment
Sudden change in mental status
Level of alertness may vary from agitation to lethargy, stupor or coma. Patients are usually drowsy and
may require repeated explanations from caregivers and examiners. Early signs of delirium may be
inaccurately attributed to anxiety.
Abrupt disturbances in sleep patterns or changes in level of activity should raise suspicion.
Interview caregiver and observe patient to assess functional status
Clinical Manifestations
Impaired memory, orientation: difficulty with abstractions, difficulty with sequential thinking, impaired
temporal memory, impaired judgment
Disturbances in thought and language with decreased verbal frequency
Disturbances in perception: visual hallucinations, paranoid delusions
Disturbances in psychomotor function: hypoactive, hyperactive or mixed
Disturbances in sleep-wake cycle with daytime lethargy, night time agitation
Affective lability: rapidly changes from one emotional state to another
Neurologic abnormalities: Tremors, Myoclonus, Nystagmus, Ataxia, Cranial Nerve Palsies, and Cerebellar
signs
Nursing Interventions
Address underlying condition such as metabolic abnormalities, sepsis, anaemia, CNS infections and
Malignancies, Antiretroviral therapy, Opioids, and Illicit substance use
Provide safe and consistent environment and increase supervision of patient as indicated
Communicate in clear simple terms to avoid misconceptions
Educate patient and family regarding care and procedures, medications, expected outcomes, and need
to orient patient to person, time, place, and situation
Ensure patients activities of daily living are met
Pharmacologic: Low doses of Neuroleptics (Haldol or Risperdal) to treat confusion or agitation
The purpose of the baseline laboratory evaluation is to 1) stage the HIV disease, 2) rule out concomitant
infections and 3) determine baseline safety parameters. The following tests are recommended
Essential Optional
Confirm HIV infection: HIV status must be Fasting lipid profile: May be recommended
documented. Refer to ICTC if in doubt. in patients with established coronary disease
risk factors or if Stavudine, Efavirenz, Protease
Inhibitor (PI) use is contemplated.
Specific investigations to rule out OIs Pregnancy test: EFV is contraindicated in
depending on the clinical need pregnancy
CD4 counts: all patients should have a Anti-HCV Screening: The prevalence of HCV is
baseline screening low in HIV infected patients except, such as in
north-eastern states of India where injection drug
use is a risk factor. It is also recommended in
HIV infected haemophiliacs and thalassaemics.
CBC: Hb, TLC, DLC, ESR, GBP Chest X-ray : To rule out TB or other pulmonary
infection
LFTs: Necessary to find evidence of hepatitis, Plasma viral load (PVL): A baseline PVL may
particularly when NVP use is contemplated. not be necessary. With optimum adherence and
a potent regimen, undetectable levels at 6 months
after ART initiation should be achieved.
Urine routine: To evaluate proteinuria and
sugar (necessitate estimation of blood glucose)
HBsAg: To rule out concomitant hepatitis B
infection as this can influence choice of ARV
regimen. Additionally, abrupt stopping of anti-HBV
drugs like Lamivudine and Tenofovir is not
recommended in patients with chronic Hepatitis B
co-infection since it may result in Hepatitis B
flare-up. This screening is mandatory for IDUs
and transfusion-associated HIV infection
HCV screening: mandatory for IDU and
transfusion- associated HIV infection
VDRL/TPHA (syphilis screening): especially
with persons of high risk behaviour group, history
of STIs and/or suggestive symptoms of syphilis
Pap smear : Helps in earlier diagnosis of
cervical intraepithelial neoplasia (CIN)
Diagnosis of HIV status in infants/children is very important in order to plan their care, support and treatment.
HIV DNA-PCR would provide testing for HIV-exposed infants and children < 18 months. Serology for HIV
antibodies, which is the gold standard for diagnosis in adults cannot be used for children below 18 months
due to false positive results because of presence of maternal HIV antibodies in the infants blood which
cross react.
In order to establish if the infant/child has acquired HIV infection, the DNA of the virus has to be detected
in the infants blood through the Polymerase Chain Reaction (PCR). The test specimen for DNA PCR can
be collected in two ways:
1. Dried Blood Spot (DBS): Infant/childs blood is collected on filter paper by heel/finger/ toe prick and
this specimen is sent to the laboratory, where the DNA PCR test is performed.
2. Whole Blood (WB): Infant/childs blood is collected in a microtainer/vacutainer and this specimen is
sent within a few hours to the laboratory where the actual DNA PCR test is performed.
Plan for HIV diagnosis among HIV exposed infants/children below 18 months
In infants between 6 weeks to 6 months of age:
Perform DNA PCR on DBS specimen collected at ICTC
If DNA PCR shows not detected follow up at ICTC
If DNA PCR shows detected refer to ART Centre for testing on WB specimen
Perform DNA PCR on WB specimen at ART Centre
If DNA detected on WB specimen at ART Centre, register and follow up at the ART Centre as per national
paediatric ART guidelines
If DNA not detected on the WB specimen at ART Centre, collect fresh WB specimen
Use the result of this specimen for further management
In infants/children between 6 months to 18 months of age:
Perform antibody test at ICTC
If antibody test is negative, follow up at ICTC.
If antibody test is positive proceed for DNA PCR
Perform DNA PCR on DBS specimen collected at ICTC if antibody test is positive
If DNA PCR not detected on DBS follow up at ICTC
If DNA PCR detected refer to ART Centre
Perform DNA PCR on WB specimen at ART Centre
If DNA detected on WB specimen at ART Centre, register and follow up at the ART Centre as per national
paediatric ART guidelines.
If DNA not detected on the WB specimen at ART Centre, collect fresh WB specimen.
Use the result of this specimen for further management
The HIV DNA-PCR results will be communicated from the reference lab to ICTC/ART collection centre
whichever applicable
Infants/children showing uninfected must continue to be followed up at the ICTC till 18 months as
per algorithm
Ensure definitive diagnosis of all infants/children by antibody tests at 18 months
All 3 antibody tests are to be used at 18 months for confirmatory HIV diagnosis, irrespective of the
first test results
Introduction
Pediatric HIV infection is an evolving entity and continues to be a challenge for the medical community. The
standard diagnostic tool for HIV infection in adults, testing for antibodies to HIV antigens, has limited utility
in infants less than 18 months of age because of the transplacental transfer of maternal antibodies. An
essential priority in caring for HIV-infected children is accurate and early diagnosis of HIV.
The diagnosis of HIV in infants under eighteen months of age must therefore be conducted by direct
detection of the virus-specific genetic material. The assay can be conducted successfully on DBS specimens.
Use of DBS facilitates access to DNA PCR testing given its high sample stability and low biohazard, which
facilitate sample handling and transport from the clinic to the laboratory. This sample type, which can be
taken from a heel prick, requires a reasonably small amount of blood and is therefore well suited for routine
testing in infants, where blood volumes are small and blood draws are challenging. The use of DBS with
this assay is a strong advantage and is the preferred method of sample collection.
This describes a procedure for collection, packaging and transport of a dried blood spot (DBS) sample from
an infant below 18 months of age. A correct performance of the DBS collection using the aseptic technique
is critical to ensure the safety of the procedure and to assure the quality of the test results obtained thereof.
An optimal sample collection also contributes significantly to the comfort and satisfaction of the donors thus
encouraging retesting as and when required
Dried blood spots (DBS) should be made only by nursing personnel who have been appropriately trained
in both the making of dried blood spots and in universal blood and fluid precautions
Material Required
Sterile disposable Lancet with tip less than 2.4mm
Sterile Alcohol preparation ( 70% isopropanolol)
Sterile Gauze pad
Soft cloth
Blood collection form
DBS card[ specially formulated commercially available absorbent filter paper( Schleicher & Schuell 903
or Whatman BFC 180); (do not use ordinary filter paper)]
Gloves( powderless)
Discard jar with 5% Sodium Hypochlorite
Method
1. Obtain proper written informed consent from the parent/ guardian with appropriate
pre test counselling
2. Complete ALL information on the collection/ test requisition form. Write patient identification
information on a new clean filter paper card
10. This figure below shows how an acceptable good quality DBS should appear. ID information
should be placed on the card. Each printed circle should have been filled with blood
Acceptable Sample
Documentation
Document and maintain all consent forms
All necessary documentation and pertinent information of every sample collected and dispatched to the
lab for testing must be made in the designated register / computer
All samples sent to the lab for testing must be accompanied by the test requisition forms and a compiled
delivery checklist that carries a list and pertinent information of all the samples being dispatched from
the collection site to the testing laboratory
Record of failed attempts at taking a heel prick sample must be recorded .
Material Required
Plastic ziplock storage packs
Dessicant packs
Humidity indicators
Biohazard labels
Glassine paper
Paper envelopes
Padded envelopes
Stapler
Gloves( powderless)
Method
2. You can store up to 15 cards in a single 3. Place DBS cards inside the storage
zip-lock bag. bag gently
Transportation
2.
Place the previous envelope inside a padded labelled
envelope to avoid damage to the DBS during postage/
courier transportation.
Place the test requisition forms and the compiled
delivery checklist in a separate zip lock bag and
place it in this padded envelope
Staple the envelope shut.
Place another biohazard sticker on the side carrying
the address of the testing site
3. Use a reliable and tested courier/ mailing system for transportation of the sample packages
Day 0
(baseline) At At 1 At 2 At Every As needed
Before or at 15 days month month 3 month 6 month (symptom-
start of ART Directed)
Clinical and
adherence
counselling
Weight
Hb
(if on AZT) (if on AZT)
ALT* * *
(if on NVP) (if on NVP)
Urinalysis
(if on TDF)
Lipid profile
(if on EFV (if on d4T,
and PI) EFV or PI)
Random
Blood sugar (if on PI)
CD4
Pregnancy
testing for (if planning
women with for EFV)
pregnancy
potential
Plasma Viral
Load**
Notes:
* For HBV and/or HCV co-infected patients, 3-monthly screening of Liver Function is recommended.
** Plasma Viral Load (PVL): The national programme does recommend routine viral load monitoring as part
of the programme. Viral load measurement is not recommended for decision-making on initiation or regular
monitoring of ART in resource-limited settings (WHO 2006). It may be considered for making diagnosis of
early treatment failure or to assess discordant clinical and CD4 findings in patients suspected of failing ART.
Scheduled follow up during the initial months of ART is necessary to diagnose and efficiently manage acute
adverse events, work with the patient on adherence issues, and diagnose clinical conditions like IRS and
new episodes of OIs.
This prong focuses on the parents-to-be. HIV infection cannot be passed on to children if their parents are not
infected with HIV. This consists of promoting safer and responsible sexual behaviours which include, where
appropriate, delaying the onset of sexual activity, practising sexual abstinence, reducing the number of sexual
partners and using condoms. The strategies here include condom provision, early diagnosis and treatment of
STIs, HIV counselling and testing , and suitable counselling for the uninfected so that they remain HIV negative.
This prong looks at the family planning needs of the HIV infected women. With appropriate support, women
who are aware of being sero-positive can plan their pregnancy and therefore reduce the possibility of passing
the virusto their future children. They can also take measures to protect their own health. The strategies here
include high-quality reproductive health counselling and providing effective family planning measures such as
effective contraception, and early and safe abortion in case the womandecides to end the pregnancy. At the
ICTC, post-test counselling should cover this information if the client is in a position to absorb it, namely inform
sero-positive clients that they are capable of transmitting the HIV to others including their spouses and in the
case of women, to the children theymight bear. They should be informed that a counselling personnel can
explain to them how to reduce the risk of transmission and invite them to come back for more information
whenever they feel the need.
Specific interventions to reduce transmission from a woman living with HIV to her child include HIV counselling
and testing, ARV prophylaxis and treatment, safe delivery practices, and safer infant feeding practices.
Specifically this involves:
Decreasing viral load Monitoring and treating infections
Supporting optimal nutrition
Avoiding premature rupture of membrane and invasive delivery techniques
Treating infections such as STIs
Promoting safer infant feeding
When an ARV drug is given to prevent transmission from the mother to the infant, it is referred to as ARV
prophylaxis. This is different from ARV treatment for the mother the mother which is used to treat her HIV
disease.
Medical care and social support are necessary to help the woman living with HIV to address and manage her
worries about her own health and that of her family. If she is assured of receiving adequate care for herself and
her loved ones, she is more likely to undergo HIV testing, and also adhere to the treatment.
The service elements here include prevention and treatment of OIs, ARV treatment, palliative (pain-reducing)
and non-ARV care, nutritional support, reproductive health care and psychosocial support.
Thus, a comprehensive PPTCT programme provides a continuum of care for the mother and the child. The
continuum begins with educating adolescent women about primary prevention of infection and continues
through treatment, care and support to HIV-positive women and families. It ensures that women receive education
and services to reduce the risk of mother-to-child-transmission throughout pregnancy, labour and childbirth,
and infant feeding. It also provides support for both mother and child, especially during the crucial years of
childhood growth and development. This comprehensive approach ultimately provides linkages to existing
community services to address the complex needs and issues involved in HIV prevention, treatment and
management.
2. HIV-infected sperm can directly infect the infant even if the mother does not have HIV infection.
False- Although there is HIV in male semen, there is no HIV in the sperm. Therefore, the mother could get
HIV infection from the male semen but the foetus could not get HIV infection from the males sperm. The
foetus can only acquire HIV infection from exposure to the mothers blood or vaginal/cervical secretions
during pregnancy, birth, or breast milk during breast feeding. Remember that about 70% of time, the foetus
will not get HIV infection at all.
3. If a woman is HIV+, there are medications she can take to reduce the likelihood of passing the
virus to her infant
True- If a woman is HIV+, she can be prescribed ART depending on clinical criteria either during her
pregnancy. She should be given ART during labour, and the baby must be given ART within 72 hours of
birth. Details of ART to prevent mother to child transmission will be dealt with in this unit. If she is on ART
and her viral load is suppressed, her risk of transmission is very low, about 1 or 2%
4. If both parents are HIV +, using condoms during pregnancy isnt necessary
False - One partner may transmit a resistant virus to the other through sexual intercourse so it is essential
that the couple practice safe sex with use of condoms.
5. If a woman is HIV positive, all her babies will be HIV-infected because they share the same
blood.
False - The mother and baby do not share the same blood. The mothers blood is filtered by the placenta
so the baby gets oxygen and nutrients without exchange of blood. The baby can only become infected if
she/he is exposed to the mothers blood. This may happen from an infection in the placenta, a maternal
abruption or abdominal trauma causing bleeding into the amniotic sac, or during birth. It is also important
to note that even with exposure to the mothers blood during pregnancy and birth, there is only about a
30% chance of the baby becoming infected.
6. Procedures during delivery that may cause exposure of the newborn to maternal body fluids
should be avoided whenever possible
True - This includes artificial rupture of membranes, forceps or vacuum delivery, episiotomy, or vigorous
suctioning of the infant.
7. If an HIV positive woman has a Caesarean section (C/S), her risk of having a baby with HIV
is 0%.
False - Although in some cases, when the womans virus is not suppressed or she has advanced HIV
disease, a C/S may reduce the risk of infection, it will never reduce it to 0%. The actual risk depends on
the severity of disease and the actual viral load. When a woman is on ART and her viral load is fully
suppressed, there does not appear to be an advantage to C/S. Also, there is a higher risk of maternal
infection and mortality with C/s and the higher cost to consider.
8. Giving Nevirapine to babies after they are born is like giving a nurse post-exposure prophylaxis
after a needlestick injury.
True. Giving Nevirapine is like giving PEP to a nurse after a needle stick injury.
Advantages Breast milk increases Breastfeeding provides infants with optimal nutrition,
PTCT risk by up to 20%. reduces morbidity and mortality associated with
Not breastfeeding at infections other than HIV, and delays the mothers
all eliminates this risk return to fertility.
completely Baby would have received all the anti-infective
available in breast milk
Bonding between the mother and baby is better
The babys gut is safe from any mucosal injury
reducing the chance of infection
It is economical and considerably more safe to breast
feed than to bottle or spoon feed the baby
At 6 months of age, breast milk alone may not be
enough to meet the nutritional needs of the baby,
hence complementary or weaning foods could be
introduced
What to Formula feeding will be Formula feed is All under second option
Assess to acceptable considered to be plus
Help Mother affordable expensive If socio-economic
Decide Option feasible unsustainable over situation is such that
safe the long term safe and sustainable
sustainable unsafe exclusive alternate feeds
cause for social cannot be provided
problems even after 6 months
risk for mixed feeds
unacceptable
Additional Why never to give Teach mothers how to express breast milk and give
Information mixed feeding. it safely if there is risk for cracked nipples, mastitis
to Provide With formula feeds that could increase the risk of HIV transmission
to Mothers microscopic mucosal Reinforce feeding hygiene if expressed breast
injury to gut is high milk is given
If mixed feeds (i.e. Good breast feeding practices: position of the mother
breast milk and other and the baby as well as breast hygiene
milk such as cows How to stop breast-feeding abruptly - it is important
milk) are given the if mother has been feeding directly to teach mother
chance of HIV to enter how to express breast milk at least two weeks
the increases risk of before stopping abruptly.
HIV transmission. Baby gets used to feeding with a cup/spoon/ palada
Infant feeding hygiene. Amount of breast milk supply reduces
Preparation of formula To practice safer sex while breastfeeding to
milk prevent reinfection and higher viral load
References to NGOs/
support centres which
may provide free/
subsidized alternate
feeds
Yes No
If answers are No, see what patient education/ linkages can be provided to support replacement feeding
OR advise safe breastfeeding.
Does the child (if old enough) understand the need to take ARVs?
How will ARVs fit into childs daily activities?
How will ARVs fit into the childs going to school?
Does the child know that ART is to be taken life long?
Is the child aware of how to store the medication?
Is the child aware of the side effects?
Is the child aware of toxicities?
How did the parent cope with his or her own HIV diagnosis?
How did the family coping with the HIV diagnosis of the parent/s?
How did the parent/s cope with the childs HIV diagnosis?
How did the family cope with the childs HIV diagnosis?
Promoting adherence is multi-faceted and must be a continuous process. This is a task that requires
excellent skills, addressing both the childs needs and issues and those of the caregiver:
The child MUST be involved
Assessment of child & family prior to child commencing ARVs
Assist families in developing routine for ARVs; ARVs should NOT dictate every aspect of daily life
Open, supportive approach
Age-appropriate explanations to child regarding need for medication
Children cope far better when they are able to understand what is happening to them and
have a sense of control
Use child-sensitive, age-appropriate explanations such as you need the medicine to keep
you strong and prevent infections
Continuing support and re-assessment of each child and familys situation
Peer support: Support from other parents and children
A variety of strategies may be used to help encourage the child to take ARVs and to assist and
support the caregiver. Some methods are mentioned below. They could be used one at a time or
in combination:
Trial runs: Finding out the best way that the child would take the medicine
Play therapy:
Having a doll /puppet and showing the child how the doll or the puppet felt better after taking
some medicine
Then asking the child whether they would like to try the same
Sticker charts:
Having a chart with dates mentioned and timing.
Every time the child takes the medicine with no trouble, giving the child a golden star, little
trouble a silver star and lots of trouble, a colour that the child does not like
At the end of the month, telling the child the child would be given some reward if there were
more golden stars on the chart. Rewards cold be simple like taking the child to the park,
giving the child a big hug, or doing something that child likes to do with the parent/caretaker
Art therapy:
Making the child draw out what he or she feels about taking medicines. This could be a
way for the child to express self
Taking medication with parent:
Giving the child the medicine along with the parent
Asking the child to put the medicine in the parent/s mouth and checking whether he/she has
taken it
Then the parent could do the same for the child
Support groups:
Arranging meetings of children taking ART so that they could express their challenges,
how they deal with it etc.
Using growth charts Infants and children who are well and healthy should gain weight and length/height.
Infants and children who are growing normally follow a growth curve parallel to one of the standard growth
curves. Weight loss or failure to gain weight can be identified by observing the childs weight over time.
When the growth curve flattens and is no longer parallel to the chart line, this indicates the need for clinical
assessment, management and nutritional intervention and possibly ART.
Dosing is twice daily Drug Child Children 6 weeks of age and above,
(paediatric fixed dose Strength till 24.9 kg
combination, FDC) (mg) Number of tablets or ml by weight band,
morning and evening
3-5.9 kg 6-9.9 kg 10-13.9 kg
AM PM AM PM AM PM
Zidovudine Lamivudine
2-drug FDC AZT/3TC 60/30 1 1 1.5 1.5 2 2
Zidovudine Lamivudine
Nevirapine
3-drug FDC AZT/3TC/NVP 60/30/50 1 1 1.5 1.5 2 2
Stavudine Lamivudine
2 drug FDC d4T/3TC 6/30 1 1 1.5 1.5 2 2
Stavudine Lamivudine
Nevirapine
3-drug FDC d4T/3TC/NVP 6/30/50 1 1 1.5 1.5 2 2
Lopvinavir/ritonavir
syrup 80/20
2-drug FDC LPV/r syrup per ml 1 ml 1 ml 1.5 ml 1.5 ml 2 ml 2 ml
Lopvinavir/ritonavir
tablet
2-drug FDC LPV/r tablet 100/25 2 1
Note:
When starting NVP regimen start with lead-in- period for 2 weeks
i.e. For first 2 weeks of ART initiation
Morning dose: AZT + 3TC ........ two-drug FDC
Evening dose: AZT + 3TC + NVP ........ three-drug FDC
HIV-TB co-infection is one of the most challenging issues in the effort to scale up ART since more than
60% of PLHA develop TB. Patients with TB merit special consideration because the co-management of HIV
and TB is complicated by drug interactions between Rifampicin and NNRTIs and PIs; IRIS; pill burden;
adherence; and drug toxicity. Active TB is the commonest OI among HIV-infected individuals and is also
the leading cause of death in PLHIV.
The management of patients with HIV and TB poses many challenges, including patient acceptance of both
diagnoses. HIV-infected persons with TB often require ART and WHO recommends that ART be given to:
All patients with extra pulmonary TB (stage 4), and all those with pulmonary TB (stage 3) unless CD4
count is >350 cells/mm3
ART reduces the incidence and recurrence of TB, as well as the fatality rates.
Initiation of first-line ART in relation to anti-TB Therapy (Based on 2006 WHO Guidelines)
Notes:
i) Timing of ART initiation is based on clinical judgement, in accordance with other signs of immunodeficiency
and WHO clinical stages. In the case of extrapulmonary TB, ART should be started as soon as TB treatment
is tolerated, irrespective of the CD4 count.
ii) ART should be started as soon as TB treatment is tolerated, particularly in patients with severe
immunosuppression.
(Take to annexure) Nurses can use of the Faces Pain Rating scale given below for children who might find
it difficult to describe the intensity of pain in terms of numbers.
When conducting an assessment of pain, remember to follow the guidelines given in the box below
A Always ask! Ask about pain regularly; Assess pain systematically. Ask family members,
friends or caregivers, if necessary.Be aware of those persons who cannot communicate.
If potential for pain exists, assume it is present until proven otherwise!
B Believe the patient and the family
C Choose treatment options appropriate to the patient and family
D Deliver medications round the clock with adequate break through medication
E Evaluate results frequently; empower patient and family members to control
Music acts like a magic key, to which the most tightly closed heart opens.
Maria Von Trapp
And the ability to experience an altered state of physical arousal and subsequent mood by processing
a progression of musical notes of
varying tone,
rhythm, and
instrumentation
for a pleasing effect.
Biochemical theory
states that music is a sensory stimulus that is
processed though the sense of hearing.
HIV/AIDS prevention activities were undertaken immediately after the first case of HIV infection was
detected in Chennai (formally Madras)
A comprehensive National AIDS Control Program (NACP) was initiated in 1992 with the establishment
of the National AIDS Control Organization (NACO) within the Ministry of Health and Family Welfare,
Government Of India.
The first phase of the program, NACP I, was implemented by NACO and Dedicated State AIDS Cells
in all the states between 1992-2004.
The second pahse of the program,NACP II saw an expanded response against the HIV/AIDS epidemic
with the establishment of State AIDS Control Societies.This program was implemented between 1999
to 2006
Under NACP III, (2006-2012), the goal is to halt and reverse the epidemic in India over the next five
years.
Prevent infections through saturation of coverage of high-risk groups with targeted interventions (TIs)
and scaled up interventions in the general population.
Strengthen the infrastructure, systems and human resources in prevention, care, support and treatment
programmes at district, state and national levels.
Office of NACO
14. Gujarat Gujarat State AIDS Control Smt. Vijaya Laxmi Joshi PD 079 2680211-13 2680214 cohealth@gujarat.gov.in
Society, 0/1 Block, New Mental Dr. Pradeep Kumar APD 2685210 drpkumar_55@yahoo.com
Hospital, Complex, Menghani Narendra Gohil (TI) JD gujaratsacs@gmail.com
Nagar, Ahmedabad - 380016 AD
15. Haryana Haryana State AIDS Control Dr. Narbir Singh PD 0172 2585413 2585413 haryanasacs@gmail.com
Society, SCO - 10, Sector - 10, APD 2584549(PD)
Panchkula, Haryana JD
AD
16. Himachal Himachal Pradesh State AIDS Ms. Sulakshna Puri PD 0177 2621608 221314, hpsacs@gmail.com
Pradesh Control Society, Block No. 38, APD 2625857 225857
Ground Floor, SDA Complex, Ms. Meena (TI) JD
Kasumppti, Shimla - 171009 AD
17. J&K J & K State AIDS Prevention Dr. M. A. Wani PD 0194 2476642 2471579 jksacs@gmail.com
and Control Society, APD
1st Floor, Khyber Hotel, Khayam JD
Chowk, Srinagar AD
18. Karnataka Karnataka State AIDS Prevention Sh. R. R. Janu PD 080 22201438 22201435 ksapsho@gmail.com
Society, No.4/13-1, Crescent APD
Road, High Grounds, Ms. Chandrakanta (TI) JD
Bangalore - 560001 AD
19. Jharkhand Jharkhand State AIDS Control Mrs. Aradhana Patnaik PD 0651 2309556 2562621 jharkhandsacs@gmail.com
Society, Sadar Hospital Campus, Dr. Raj Mohan APD 2490649
Purulia Road, Ranchi Ms. Kavita (TI) DD -TI
AD
20. Kerala Kerala State AIDS Control Dr. Usha Titus PD 0471 2304882, 2305183 keralasacs@gmail.com
Society, IPP Building, Red Cross APD 2305183 09447030470
Road, Thiruvananthapuram, Sh. Dennis (TI) JD-TI
Kerala - 695037 AD
21. Lakshadweep Lakshadweep AIDS Control Sh. K.P. Hamzakoya PD 04896 262316, 262817 lakshyadweepsacs@gmail.com
Society, Directorate of Medical APD 262317,
and Health Services, JD 262114,
UT of Lakshadweep, AD 263582
Kavaratti - 682555
22. Madhya Madhya Pradesh State AIDS Arun Tiwari PD 0755 2559629 2556619 mpsacs@gmail.com
Pradesh Control Society, 1, Arera Hills, APD
Second Floor, Oilfed Building, JD
Bhopal - 462011 Sh. Rajneesh Bhatnagar AD-TI
23. Maharashtra Maharashtra State AIDS Control Sh. Ramesh Devakar (IAS) PD 022 24113097, 24113123, ramesh.devakar1@gmail.com
Society, Ackworth Leprosy APD 24115791 24115825 maharashtrasacs@gmail.com
Hospital Campus, Behind SIWS Ms. Shivaranjani JD-TI
Collete, R.A. Kidwai Marg, AD
Wadala (West), Mumbai - 400031
24. Manipur Manipur State AIDS Control Sh. P.K. Jha PD 0385 2414796, 2310796, manipursacs@gmail.com
Society, Room no. 202, APD 2411857, 2222629,
Annexee Building, Western Block Abhiram Mongjam JD-TI 2229014 2224360
Medical New Secretariat, AD
Imphal - 759001
25. Meghalaya Meghalaya State AIDS Control Dr. Mrs. S.M. Garod PD 0364 2223140, meghalayasacs@gmail.com
Society, Ideal Lodge, Oakland, APD 2315452,
Shillong - 793001 JD 2315453
AD
26. Mizoram Mizoram State AIDS Control Dr. Eric Zomawia PD 0389 2321566 2320922 mizoramsacs@gmail.com
Society, MV-124, Mission Veng APD
South, Aizwal - 796005 Betty JD-TI
AD
27. Mumbai Mumbai District AIDS Control Dr. S.S. Kudalkar PD 022 24100245-49, 24100245, mumbaimacs@gmail.com
District Society, Acworth Complex, APD 24100250 24100250
Behind SIWS College, Ms. Uma Mehta JD-TI
R.A. Kidwai Marg, Wadala (West), AD
Mumbai - 31
28. Nagaland Nagaland State AIDS Control Dr. Niphe Kire PD 0370 2244218, 2242224 nagalandsacs@gmail.com
Society, Medical Directorate, APD 2241046,
Kohima - 797001 Dr. Barnice JD-TI 2222626,
AD 2233027
29. Orissa Orissa State AIDS Control Dr. Alekh Chandra Padhiary PD 0674 2405134, 2407560, orissasacs@gmail.com
Society, 2nd Floor, Oil Orissa APD 2405104-06 2405105
Building, Nayapalli, Ms. Smita Jagdev JD-TI 2393415 2394560
Bhubaneshwar-12 Santanu AD-TI
30. Pondicherry Pondicherry State AIDS Control Dr.D. Gurumurthy, M.B.B.S. DD PD 0413 2343596, 2343596 pondicherrysacs@gmail.com
Society, No. 93, Perumal Kail APD 2337000
Street, Pondicherry JD
AD
31. Punjab Punjab State AIDS Control Sh. Satish Chandra IAS PD 0172 2743442 pbsatishias@gmail.com
Society, 4th Floor Prayaas APD punjabsacs@gmail.com
Building Sec-38B, Chandigarh JD
Ms. Meenu, Deputy Director DD-TI
32. Rajasthan Rajasthan State AIDS Control Dr. R.N.D. Purohit PD 0141 2381792, 2381792 rajasthansacs@gmail.com
Society, Medical and Health Dr Katara APD 2381707,
Directorate, Swasthya Bhawan, Ms. Rolly Sinha JD-TI 2383452,
Tilak Marg, C Scheme, Dr Raja Chawla DD-STI 2383282,
Jaipur - 302005. 2382765
33. Sikkim Sikkim State AIDS Control Dr. Namgyal T. Sherpa PD 03592 225343, 220896 sikkimsacs@gmail.com
Society, STNM Hospital, APD 220898,
Gangtok, 737101 JD 32965
Sh. Karan Sharma AD-TI
34. Tamil Nadu Tamil Nadu State AIDS Control Tmt.P. Amudha, IAS PD 044 28194917, 28190261 tnsacs@gmail.com
Society, 417, Pantheon Road, APD 28190467
Egmore, Chennai - 600008 Vender Vendan JD-TI
AD
35. Tripura Tripura State AIDS Control Dr. Keshab Chakraborty PD 381 2321614 dr.keshab@rediffmail.com
Society, Health Directorate APD tripurasacs@gmail.com
Building, Gurkhabasti, Sh. Rabendra Sen
P.O. Kunjaban, Agartala, AD
West Tripura - 799006
36. Uttar Uttar Pradesh State AIDS Sh. S.P.Goyal (IAS) PD 0522 2721871, upsacs@gmail.com
Pradesh Control Society, A Block, Ms. Kumudlata APD 2720360,
PICUP Bhawan, Vibhuti Khand, Ms. Preeti JD-TI 2720361,
Gomati Nagar, Lucknow - 10 Mr. Sheetal Prasad AD-TI 2283168
37. Uttaranchal Uttaranchal State AIDS Control Dr. D.C. Dhyani PD 135 2728144, 2728144 uttaranchalsacs@gmail.com
Society, Chandar Nagar, Sh. Sanjay Bisht DD-TI 2720377,
Dehradun. JD 2728155
AD
38. West Bengal West Bengal State AIDS Control Dr. R. K. Vats PD 033 23574400, 23570122 wbsacs@gmail.com
Society, Swasthya Bhavan, Dr. S. P. Banerjee APD 23570122,
GN-29, Sector-V, Salt Lake, Ms. Kiran Mishra JD-TI 23576000
Kolkatta -700091 Ms. Anindita Maity AD-TI
The CCC plays a critical role in enabling PLHIV to access ART as as providing monitoring, follow up
and counselling support to those who are initiated on ART, positive prevention, drug adherence,
nutrition counselling etc. The monitoring of PLHIV, who do not require ART as yet (Pre ART) will also
be a critical function that needs to be carried out by CCC.
A Community Care Centre (CCC) is a place with facilities for Out Patient and In-Patient treatment where
a PLHIV receives the following services:
All PLHIV started on ART (at the ART Centre) will be sent to the CCC for a minimum of 5 days
of In patient care and be prepared for ART
Treatment of OIs
Appropriate referrals to ICTC,PPTCT and ART Centres
Out Patient Services
Home Based Care
Some CCCs will serve as Link ART Centres
Condom Distribution
Staff at CCC comprises of;
Doctor 1 Full time or 2 Part time
Project Coordinator 1 Full Time
Counsellor 1 Full Time
Out Reach Workers 4
Laboratory Technician 1 Part Time
Nurses 3
Cook 1
Helper 1
Janitor 2
Under NACP III, it is proposed to set up 350 CCC over a period of 2007-2012 through PLHIV networks,
NGOs and other Civil Society Organizations
The CCCs are being established on priority,in districts which have high levels of HIV prevalence and
high level PLHIV plod and will be linked to the nearest ART centre.
30 Andhra Pradesh Rural India Slef East Godavari A Rural India Slef N. Slesser Babu, 0883-2425367,
Development Development Trust, Coordinator 2420094,
Trust PB No-56, # 90-1-5/1, Mr. R. Praveen Das 9848185494,
Swaraj Nagar, 9440456772
A.C. Gradens,
Rajamandry -533101
31 Andhra Pradesh Mariyanilayam Kurnool A Mariyanilayam Social Sr. Samestha DSS, 9849517026
Social Service Service Society, Incharge 9441336003
Society Gargeyapuram, Kurnool. Sr. Deepthi 08518-200245
32 Andhra Pradesh Perali Narasaiah Nizamabad A Perali Narasaiah Dr. P.B. Krishna Murthy 08462-231060
Memorial & Memorial & Charitable R. Venkat Gopi 9849290234
Charitable Trust Trust, C/O Sree Rama 9490065888
Eye Hospital,
Khaleelwadi, Nizambad
33 Andhra Pradesh Freedom Secundrabad A Freedom Foundation, Jayasingh Thomas 9908582655
Foundation 21, Cariappa Road, Kishore Kumar 9848602446
Alwal, Bolarum, 040-27861023
Secundrabad.
34 Andhra Pradesh Rakshana Ranga Reddy A Rakshana Deepam, Sr. K. Clarit, 9441958720
Deepam 44-15/2, Survey No.113, Project Holder 9959543227
Himayat Nagar (Village), Sr. Swarnalatha 08413-235130
Via CBIT
35 Andhra Pradesh Viswakaruna Warrangal A Viswakaruna Fr. Jyothish 9849571049
Dermotoligical Dermotoligical Center, Sr. Pennamma 9440945756
Center Fathima Nagar, NIT Post 08711-223457
36 Andhra Pradesh Rajiv Gandhi Guntur A Rajiv Gandhi Asian Dr. Venkatappa Reddy, 9885623718
Asian Studies of Studies of Immunology Director 9848213718
Immunology (RASI) (CCC), Smt. M. Malleswari 0863-2223023
(RASI) D.No.13-8-147, 8th Line,
G.V. Thota, Opp. R.T.C.
37 Andhra Pradesh Ganne East Godavari A Ganne Subbalakshmi Dr. Ganesh 9959999805
Subbalakshmi Medical College (GSL) B.V. Soma Sastry 9959999802
Medical Dr. Jammy Rajesh 9989924783
040-30421517/18/19
38 Andhra Pradesh Kamineni Institute Nalgonda A Kamineni Institute of
of Medical Medical Sciences (KIMS),
Sciences (KIMS) Nalgonda
39 Andhra Pradesh APAIDSCON Medak A Dr. Ganesh 9959999805
B.V. Soma Sastry 9959999802
Dr. Jammy Rajesh 9989924783
040-30421517/18/19
40 Chandigarh Chandigarh Chandigarh B Khuda Ali Sher, Mr. Sachin Sharma 09872888177
Community Opposite Shivalik 09463456747, (Personal),
Care Center Nursery 0172-2786040 2786040 (Office)
41 Delhi Ashraya Holistic South B ASHRAYA - Holistic Ms. Nafisa Ali 9811548345
Care Centre Care Center, Multi (9818449999), (Henry, PC)
Purpose Community Mr. Henry : 9810398059
Center, Village Rajokari, henryasimte@yahoo.com
Delhi-Gurgaon Highway,
(Near Shiv Murti),
New Delhi-110038.
42 Delhi Akankshya / North East B Community Care Centre, Project coord. Mr. Harish Tel: 22130451,
Chelsea C-120, Gali No. 2, Varma (9810571911), 22130452
Near Police Station, Mrs. Doe Nair
Bhajanpura, 9810705450,
Delhi 110053 wagchelsea@vsnl.net,
Tel: 325 66703. wagchelsea@yahoo.com
wagchelsea@yahoo.com Mr Sumit Verma
wagchelsea@wagch coordinator: 9810255143
elsea.org Dr Umesh Bhatnagar:
9811213747
Mrs Doe Nair:
9810705450
43 Delhi Bhartiya New Delhi B BPS-Care Home Project Coord. Ms. Pooja
Parivartan C-42, Conductors (22356852, 9818233876),
Sansthan Colony, Burari, Mr. Dinesh Kumar
New Delhi-110084 (980064598)
Tel: 22351052,
22351053,
bps_org@rediffmail.com
44 Delhi Deepati West B H.No 8, Indira Service Mr. Joy Jacob 9910360825
Foundation Station, Main Dhansa
Road, Najafgarh 43
45 Delhi Aradhya North West C H.No. 15, Bhalaswa Mr. Umesh 9213429305
Colony, Harijan Basti,
Near Basti, Near G.T.
Road, Karnal Bypass
46 Delhi Sahara Center Central B 1765, Pataudi House, Ms. Riti 9818474619,
for Residential Kucha Dakhni Rai, 41639167
Care & Daryaganj,
Rehabilitation New Delhi 110002
47 Delhi Snehsadan/Child North West B SNEH SADAN - Care Projct coord. Tel:27874740,
Survival India Home, House No. 618, Ms. Sheela Mann 27874182
Prahladpur Road, (9810986101),
Village Khera Khurd, Ms. Deepa Bajaj
Delhi 110082, (9810647807)
csi_org@hotmail.com
48 Haryana Red Cross Rohtak C Arpan Institute, Near Mr. Nahar Singh Deswal 01262- 310107
Society, Rohtak Govt. Sr. Sec. School,
Gandhi Nagar,
Rohtak 124001
49 Karnataka Accept, Bangalore A AIDS Care Counseling Mr. Raju K Mathew 9448619619,
Bangalore Education and acceptindia@
Prevention Training gmail.com
(ACCEPT) 245m KRC
Road, (Next to Visthar),
Dodda Gubbi Post,
Bangalore - 562149.
50 Karnataka Moolika Shimoga A Moolika Samvrudhi Dr. Chandrashekar 0818326618
(Hariappa Arogyabhivrudhi
Hospital), Prathishthana, Hariyappa
Sanvruddhi Hospital, R.P. Road,
Sagar Taluk,
Shimoga - 577401.
57 Karnataka Sri Shakti Belgaum A Sri Shakathi Association, Mr. Shashikumar 9945221004
Sri Shakthi Multi
Speciality Hospital,
Belgaum.
59 Karnataka Holy Cross Chikmagalur A Holy Cross Hospital, Dr. Bhagyalakshmi 9448130268 /
Hospital Jyothi Nagar, 08262-220077 /
Chikamagalur - 577102 220017
60 Karnataka Holy Cross Chamarajnagar A Kamagere, Kollegal, Sr. Regi John 9740664598 /
Hospital Chamarajnagar - 560068 08224-263681
62 Karnataka St. Marys Bellary A OPD Road, Cantonment, Sr. Mary Varghese 9449536191 /
Hospital Bellary 583 104 08392-242641
63 Karnataka Lourdes Dharwad A # 14337, Shanti Sadan, Sr. Nirmala Dsilva 9449483074 /
Hospital Ward 13, Block No. K A 0836 -2448224
19/2429, Nirmal Nagar
12th Cross Road,
Dharwad - 580003
67 Karnataka Karwar Diocesan Karwar A Bishops House, Fr. Lawrence Fernandes 9448129063 /
Development Baithkol Road, Karwar, 08382-220563
Council UK - 581302
68 Karnataka Haemophilia Davangere A No 352/1, 9th Cross, Dr. Suresh Hanagavadi 9341004109
Society P J Extn, Behind Mothi
Veerappa JR College,
Davanagere - 577002
69 Karnataka St Annes Bijapur A #54, Centre for Non Fr. Vincent Crasta 9448308585 /
Hospital Formal Education (CNFE), 08352-256453
Station Road,
Mukund Nagar,
Bijapur - 586104
71 Karnataka HEERA, (Health, Chitradurga A Community Care Center, Dr. Nagendra Gowda. 08194-230658,
Education, City Multispeciality M.R. 9880096765,
Empowerment, Hospital Premises, 9243205726
Rehabilitation Turuvanur Road,
Association) Chitradurga
72 Karnataka (ORBIT) Bidar A Asha Deepa, ORBIT Fr Santhosh Dias 08483 271032
Organisation for Community Care Centre,
Bidar Integral Kristhashrama,
Transformation Kaudiyal (s) ,
Basavakalyan Raluka,
Bidar District
73 Karnataka Our Lady of Kolar A Nava Jeevan Health Sr. Josena 8152223418
Mercy SAB Centre, Opp K.P.T.C.L,
Trust M.B. Road, Mulbagal,
Kolar
75 Karnataka Dakshina Dakshina A Navajeevana Care and Fr. Thomas K.C. 9008606605 /
Kannada Rural Kannada Support Centre, Kakkinje, 9448656926
Development Charmady P.O.,
Society Belthangady, D.K.,
Karnataka
76 Karnataka Asha Kiran Mysore A Asha Kiran Hospital, Mr. Gururaja 9980055905 /
Hospital CA-1, Ring Road, 984511058
Hebbal Industrial Housing
Area, Next to JK Tyres
Plant, Hebbal,
Mysore - 570016
77 Maharashtra Bel-Air Hospital, Satara A Bel Air Hospital, Fr. Tomy 09422606672,
Panchgani, Panchagani, 02168241109
Satara Satara - 412805
78 Maharashtra Acharya Vinobha Wardha A DMDPGMER, Sawangi Dr S Z Quazi, Dr Abhay 09370043029,
Bhave Rural (Meghe), Wardha Gaidhane 9325191810,
Hospital, Wardha 07152- 320750
79 Maharashtra Krupa Prasad Nasik A Krupa Prasad Kendra, Dr Dimple Chauhan, 0253- 2595586
Kendra, Nasik Old Mumbai, Agra Road, kkrupaprasad@ 9422759960
Behind Vasan Showroom, yahoo.co.in,
Mumbai Naka, digimol_2006@
Nasik 422001 yahoo.co.in
80 Maharashtra G.M. Priya Latur A G M P Hospital, Dr D William 02383- 226069
Hospital, Latur Dapegaon, Taluk Ausa,
Dist Latur - 413572
81 Maharashtra Jan Kalyan Sholapur A C/O Chaitanya Hospital, Mr. J Shilgekar 0217-2741870,
Samiti, Sholapur 538 Vithal Arcade, 2741874, 2741872
North Kasba,
Sholapur - 413001
82 Maharashtra Nirmaya Niketan, Mumbai A V N Purav Marg, Mr. John Lobo, Mr. A.S. 022-25513314,
Mumbai Dhobighat, Trombay, Gaikwad, Chairman- Fax:91-022-25581450
Mumbai - 400088, Mr. Santan DSouza, Tel: 91-022-2551
<chairman@nirama Eduljee Framjee Allbless 3314 (OPD)
yniketan.org> Niramay Niketan, Mob. No. Chairman -
V.N. Purav Marg, 9869682397,
Dhobi Ghat, Trombay, Treasurer -
Mumbai-400088 9867618832,
Co-ordinator (CCC) -
9869289347
83 Maharashtra Sarvodaya Mumbai A Lal Bahadur Shastri Mr. Krishnan 022-25152237
Hospital, Marg, Ghatkopar (W),
Mumbai Mumbai
84 Maharashtra Snehalaya, Ahmednagar A Block No 239, Near Mr. Ambadas Chavan, 0241-2778353,
Ahmaednagar Super Ammonia Plant, Mr. Anil Gawde 2327593,
Shree Tile Chowk, 9881946116
MIDC, Nimblak, 9890306407
Ahmednagar-414001
85 Maharashtra Priyadarshani Akola A Sant Tukaram Hospital, Dr. Jagannath Dhone, 0724-2433092
Rural and Tribal Gorakshan Rd, Anand Janotkar 9923584209
Upliftment Tukaram Chowk,
Foundation, Akola - 444001
Akola
86 Maharashtra Godavari Jalgaon A Godavari Foundations Dr. Ulhas Patil 0257-2200830
Foundation, CCC, Mahesh Housing Mr Yogesh Mahajan 9371616716
Jalgaon Society, Near Hotel Step
Inn, Jalgaon - 425001
87 Maharashtra Lotus Medical Kolhapur A Sona Towers, Survey Dr. Kimaya Shah 0231-2692411
Foundation, No 644, Plot No. 143/B1, 9422051305
Kolhapur YP Pawar Nagar Chowk,
Jawaharnagar Rd,
Kolhapur-416008
88 Maharashtra Balvikas Mahila Latur A Swadhar Mahila Mr. Vilas Deshpande 02382-228773
Mandal, Latur Vastigruh, Sudarshan 02382-240418
Colony, Indra Nagar,
Latur - 413512
89 Maharashtra Mure Memorial Nagpur A Maharajbagh Road, Mr. Vilas Shende 0712-2522370
Hospital, Nagpur Sitabuldi,
Nagpur-440001
91 Maharashtra Dhanvantri Nanded A Infront of Water Tank, Dr. B.K. Kardile 02462-234330
Vaidyakiya Mahavir Society, 9422186245
Pratishthan, Nanded - 431602
Nanded
92 Maharashtra Sai Sneha Pune A Sai Sneha Hospital, Dr. Sunil Jagtap 020- 26959208,
Hospital, Pune A/P Khed Shivapur 9822036736
(Bagh) Near Police
Station, Tal. Haveli,
Dist. Pune-412213
94 Maharashtra Sangli Mission Sangli A Dilasa House, Darga Fr. Sabu 0233-2211292,
Society, Sangli Mohalla, Aman Nagar, 9420678520
Malgao Rd, Miraj,
Dist Sangli-416410
96 Maharashtra Param Prasad Pune A Dr. Jal Mehta Foundation Fr. Shaju 0-9970963246
Charitable Campus, Survey No. 1,
Society Yevlewadi, Pune
98 Maharashtra Kamlini Nilmani Mumbai A Goel Hospital, J B Nagar, Ravi Patil 022 28323659 /
Charitable Trust Andheri (East), 28349714
Mumbai - 400 059 982013653
100 Maharashtra Jeevan Vikas Amravati A Navjeevan Care Centre, Fr.Jolly 07223 221352 /
Sanstha C/O Leprosy Relief & 221576 / 07223 /
Rehabilitation Centre, 223740 /
Nimbhora Khurd, 09422156032
Badnera P.O.,
Amravati Dist. - 444701
101 Maharashtra Dhanvantaris Parbhani A DOST CCC, Sadguru Dr.Jawade (02452) 241122
Organization for Nagar, Old Pedgaon Rd, 9970764224
Socio Health Parbhani-431401
Transformation
103 Maharashtra Diocese of Chandrapur A Christ Hospital, Dr. Gregory Ellyadom 07172-264387,
Chanda Society Jyoti Nagar, Tukum, 264389,
Chandrapur- 442401 09423115594
104 Maharashtra Shri Gajanan Jalna A Shrikrishna Clinic, Ganesh Sonunae 07261-232226,
Maharaj Krishi Mantha Road, Jalna 232393,
Va Shishanak 9422880291,
Santha 9881719227
105 Maharashtra Sangli Mission Ratnagiri A Navajeevan Arogya Fr. Siju 094211-22204
Society Kendra, St. Thomas
Church Campus, MIDC
PO, Karwanchi Wadi
Road, PB-12,
Ravindranagar,
Ratnagiri - 415639
107 Maharashtra Hope Centre Mumbai Andheri The Catholic Nurses 9892950509
Guild of India., C.N.G.I.
National Secretariate &
Hope Centre,
Mhatarpada Road,
Amboli, Andheri West,
Mumbai - 400058
108 Maharashtra Sparsh Hospital Osmanabad Sastur SPARSH Rural Hospital, 094220 95053
At Sastur, Taluka Lohara,
Dist. Osmanabad-413606
110 Maharashtra Vanchit Vikas Pune Pune Mogal Market, 2nd Floor, 020 24454658/
CCC CTS No: 1003, Budgwar 24483050
Peth, Pune - 411002
111 Maharashtra Late Shriram Dhule Dhule CCC - Late Shriram 9422788421
Ahirrao Memorial Ahirrao Memorial Trust,
Trust- Dhule-CCC Betawad, Tal. Sindkheda,
Dist.: Dhule
Pin: 425403
112 Maharashtra Late Shriram Nandurbar Nandurbar Jai Prakash Narayan 9422788421
Ahirrao Memorial Hospital Compound,
Trust- Near Meera Agency,
Nandurbar-CCC Main Road,
Nandurbar
113 Maharashtra Sant Gulab Baba Bhandara Bhandara Doctors Colony, 9823593554
CCC Takia Ward,
Behind MSEB Office,
National Highway-6,
Bhandara - 441904
114 Maharashtra Yuva CCC Beed Parli Late Suwalalji Wakekar (02446) 222891
Community Care Center,
Parli (V), Near Over
Bridge, beside
Khandinala Complex,
Hindnagar, Parli (V),
Dist. Beed - 431515
115 Manipur Centre for Canchipur A Centre for Organising Th. Promila 98562-15673,
Organising Labours Development 2406411
Labours (COLD), Canchipur,
Development Imphal West
(COLD)
116 Manipur LEWS Imphal A Leprosy Patients Welfare A. Tolen Singh 2421363(O),
Society, Lei-Ingkhol, 94360-20161,
Imphal 94360-27065
Email: lews2003man
@yahoo.co.in
117 Manipur RUSA, Moreh Moreh A Rural Service Agency Y. Surchandra Singh 98622-78785,
(RUSA), Moreh, Ward 2231145
No.9, Near Trade Center Email: rusapalace
compound@
yahoo.com
118 Manipur SHALOM Churchanpur A Society for HIV/AIDS and Ms. Lalruatpuii Pachuau 953874-33891,
Lifeline Operation in 953874-22531,
Manipur (SHALOM), 953874-33541
Churachandpur Bazar Email: shalomccp@
yahoo.co.in
119 Manipur Kha Manipur Thoubal A Kha Manipur Yoga and Dr. M. Rajkumar Singh 98620-88092,
Yoga and Nature Cure, Kakching 953848-261320
Nature Cure Thoubal District Email: ayncrh@
yahoo.co.in
121 Tamil Nadu YRG Centre for Chennai B YRG Centre for AIDS Thiru. SK. Satish Kumar 9381006380
AIDS Research Research and Education suniti@yrgcare.org,
and Education (YRG CARE), Voluntary satish@yrgcare.org
(YRG CARE) Health Services (VHS)
Campus, Taramani,
Chennai - 113
122 Tamil Nadu Sneha Sadan Dharmapuri A Sneha Sadan, Sr. Shobhana, 9486091091,
Selliampatty Village & snehasadan2007@
Post, Palacode Taluk, gmail.com
Dharmapuri
District - 636809
123 Tamil Nadu The Association Dindigul C The Association of Dr. Margret Kalaiselvi, 9944210076
of Arulagam Arulagam Hospice, margaret_larbeer@
Hospice Bangarapuram, yahoo.com,
Reddiarchatram Post, arulhos@yahoo.co.in,
Dindigul District - 624622 arulagampc@yahoo.co.in
124 Tamil Nadu Family Planning Dindigul C Family Planning Thiru. A.K. Serumalai 9952118640
Association of Association of India fpaidindigul@yahoo.com
India (FPAI) (FPAI), Plot No. 69-70, 9952118640
AJMG Nagar, 4th Lane,
Opp. to Beschi College,
Karur Road,
Dindigul District - 624001
125 Tamil Nadu Centre for Action Erode A Centre for Action and Thiru. Charles Prabhu, 9443736367
and Rural Rural Education (CARE), 9443736367,
Education (CARE) No. 6, Kambar Street, carecharles@dataone.in
Teachers Colony, Erode
126 Tamil Nadu Family Planning Madurai A Family Planning Dr. Louis S. Paulraj, 9442035900
Association of Association of India 9442035900,
India (FPAI), (FPAI), Madurai Branch, fpaim@satyam.net.in
FPAI Bhavan, FPAI Road,
TNHB Colony,
Ellis Nagar, Madurai,
Madurai District - 625010
127 Tamil Nadu Meenakshi Madurai A Meenakshi Mission Thiru. S. Palaniappan, 9842161185
Mission Hospital Hospital and Research 9842161185,
and Research Centre, Lake Area, charityrd@gmail.com,
Centre Melur Road, palaniappan_law@
Madurai District - 625107 yahoo.co.in
128 Tamil Nadu HIV Positive Namakkal A HIV Positive People Ms. S. Kausalya, 9840693679
People Welfare Welfare Society (HPPWS) 9840693679,
Society (HPPWS) No.119-28B, Madha Koil hppwscare@gmail.com
Street, Trichy Road, <hppwscare@gmail.com>
Namakkal - 637001
129 Tamil Nadu Human Uplift Perambalur A Human Uplift Trust (HUT) Dr. Raja Venkat 9842414711
Trust (HUT) Meikandar Complex, 9842414711
Kalpalayam Road, rajavenkat@hutindia.org
Mannachanallur,
Trichy - 621005
130 Tamil Nadu Sri Ponnalagi Pudhukottai A Sri Ponnalagi Amman Dr. A. Alegesan, 9344545449
Amman Trust Trust, Thottiampatty, 9344545449,
Ponnamaravathy, dralagesan@yahoo.co.in,
Pudukottai District spatrust@gmail.com
<spatrust@gmail.com>
131 Tamil Nadu Immaculate Sivagangai A Immaculate Conception Sr. Motchalangaram, 9486013389
Conception Women Development 9486013389,
Women Social Service Society st_jsph@rediffmail.com
Development of Sivagangai Province <st_jsph@rediffmail.com>
Social Service Sirpi & St. Joseph
Society of Hospital, Pulial,
Sivagangai Pulial (Post),
Province Sirpi & Devakottai (via),
St. Joseph Sivagangai - 630 312
Hospital
132 Tamil Nadu Mass Action Thiruvallur A Mass Action Network G. Babu, 9444275762
Network India India Trust (MAN), No.14, 9444275762,
Trust (MAN) 1st Floor, West Sivan, massaction@
Kovil Street, Vadapalani, rediffmail.com
Chennai - 600029
133 Tamil Nadu St. Joseph Tuticorin A St. Joseph Leprosy Sr. Rose Francis, 9442948815
Leprosy Hospital Hospital and HIV/AIDS 9442948815,
and HIV/AIDS Care Centre, joseind@gmail.com ,
Care Centre Arokyapuram, Sr. Dr. Rita
Thoothukudi
134 Tamil Nadu Holy Family Trichy A Holy Family 9443401125, 9443401125
Hansenorium Hansenorium, ritasr@sify.com
Fathima Nagar (Post),
Trichy - 620 012
135 Tamil Nadu Sri Meenakshi Ramnad A Sri Meenakshi Dr. S. Sundarraj, 9443155181
Educational and Educational and 9443155181,
Development Development srimedu@rediffmail.com
Organization Organization (SMEDO),
(SMEDO) No. 3/622 A3,
Bagawath Singh Road,
Paramakudi - 623707,
Ramanathapuram District
136 Tamil Nadu Tamilnadu Villupuram B Tamilnadu Network of Thiru. Rama Pandian, 944040469
Network of Positive People (TNP+), 944040469,
Positive People No. 10, Kalaignar, tnpluz@yahoo.com
(TNP+) Karunanidhi Street,
Chennai Main Road,
Villupuram - 605 602
137 Tamil Nadu N.A.A.DT. People Vellore A N.A.A.DT. People Thir. M.S. Rajendran, 9790571391
Welfare Service Welfare Service Society, 9790571391,
Society Dharma Nagar, Vellore msrajendran@yahoo.co.in
Govt. Medical College
Hospital back side,
Adukkambarai,
Vellore District
138 Tamil Nadu Community of Vellore A Community of People Mr.Pandian, 9894807208, 9894807208
People Living Living with HIV/AIDS in knirmala@yahoo.co.in
with HIV/AIDS in Tamilnadu (CPT+), <knirmala@yahoo.co.in>
Tamilnadu No. 5/74C, Katpadi Main
(CPT+) Road, Senrayanapalle,
Katpadi Taluk,
Vellore District
139 Tamil Nadu Sri Narayani Vellore A Sri Narayani Hospital & Dr. J. Sundra Babu, 9952416822
Hospital & Research Centre, 9952416822
Research Centre, Thirumalaikodi, snhrc_76@yahoo.com,
Vellore District - 632055 suresh1980edp@
gmail.com
140 Tamil Nadu Society of the Theni A Society of the Sisters Sr. Anestesia, 9443862311
Sisters of the of the Presentation of 9443862311
Presentation of the Blessed Virgin Mary
the Blessed Community Health
Virgin Mary Department, No. 5/73,
Community Theni District,
Health Theni - 625 531
Department
141 Tamil Nadu Ramana Thiruvannamalai A Ramana Maharishi Thiru. F. Jayaraj, 9442274235
Maharishi Rangammal Hospital, 9442274235,
Rangammal Shiva Nagar, Athiyandal sm_wright21@hotmail.com
Hospital Village, Thiuvannamalai
District - 606603
142 Tamil Nadu Society for Nagapattinam C Society for Education Tmt. A.G. Manimekalai, 9443847312
Education and and Economic 9443847312,
Economic Development (SEED) seedngo@rediffmail.com
Development No.3/273, Main Road,
(SEED) Thirumarugal,
Nagapaatinam
143 Tamil Nadu Indo Srilankan The Nilgiris A Indo Srilankan Mr. Alphone Raj M.L., 9443371224
Development Development (Island) 9443371224,
(Island) Trust Trust, No. 14/56, islandtrust@bsnl.in
Club Road,
Kothagiri - 643217
144 Tamil Nadu TCNR Virudhunagar A TCNR Padmavathi Dr. Kamalasekarn, 9443122784
Padmavathi Ammal Free Medical 94431 22784,
Ammal Free Charties (TCNRP), tcnrp86@yahoo.co.in
Medical Charties Bo. 121B, Hospital Road,
(TCNRP), Rajapalayam - 262117
145 Tamil Nadu Selvi Memorial Kancheepuram A Selvi Memorial Illam Ms. Mary Thomas, 9840541108
Illam Society, Society, No. 9, 2nd Main 9840541108,
Road, Jaya Nagar, smis99@gmail.com,
Tambaram Sanitorium, selvi_mary@sify.com
Chennai - 600 047
146 Tamil Nadu We Care Social Kancheepuram A We Care Social Service Mr. Antony, 9340001000, 9340001000
Service Society Society, No. 4/98, wecareindia@gmail.com
Nethaji Road,
Singaperumal Koil Post,
Kancheepuram
District - 603 204
147 Tamil Nadu Arogya Agam Theni A Arogya Agam, Mr. John Dalton 9842115449/
Palakombai Road, 9842115449/9842142306, 9842142306
Aundipatty, info@arogyaagam.org,
Theni - 625 512 arogyaagam@gmail.com
148 Tamil Nadu Indian Red Krishnagiri A Indian Red Cross Society Mr. P. Shanmugam, 9443331118
Cross Society (IRCS), No.8, Krishnappa 944331118
(IRCS), Layout,
Krishnagiri Krishanagiri - 635001
149 Tamil Nadu Vailankanni Thiruvarur C Vailankanni Society for Er. S. Xavier, 9842452597
Society for Rural Rural Construction and 9842452597,
Construction and Technical Education virtueorg@yahoo.co.in
Technical (VIRTUE), No.18/94-V,
Education Hospital Street,
(VIRTUE) Tiruthuraipoondi - 614713
150 Tamil Nadu Anbalayam Thanjavur B Anbalayam, No. 6/142, Thiru. K. Senthil Kumar, 9443167607
Natarajapuram South, 9443167607,
10th Cross Street, anbalayam2001@
Thanjavur - 613 007 yahoo.co.in
151 Tamil Nadu Freedom Chennai A Freedom Foundation, Mr. Varadhan, 9444041619
Foundation No. 15, Redhills Road, 9444041619
United Colony, Kolathur,
Chennai - 600 099
152 Tamil Nadu Preshistha Coimbatore A Preshistha Service Fr. Seby Vellanikaran, 9443006094
Service Society Society, Unjavelampatty, 9443006094,
Pollachi Taluk, pss_poy@yahoo.com,
Pollachi - 03, sebyvellani@yahoo.co.in
Coimbatore District
153 Tamil Nadu Isha Yoga Coimbatore A Isha Yoga Foundation, Dr. Bhavani Balakrishnan 9840804496
Foundation, Grama Puthunarvu 9840804496,
Iyyakkam, No. 13/24, isha.healthservices@
North End Road, gmail.com,
Krishnasamy Nagar, bhavani.balakrishnan@
Coimbatore - 45 gmail.com
154 Tamil Nadu Sharanalayam Coimbatore A Sharanalayam, No. 34, N. Chandran, 94443054204
Thiruvengada Nagar, 94443054204,
Pollachi - 642 001, aid@sharanalyam.org,
Coimbatore District sharanalayam@
rediffmail.com
155 Tamil Nadu PEACE TRUST Tirnelveli B PEACE TRUST, No. 15, Dr. R. Anburajan, 9442612138
Kurichi Road, 9442612138,
Kulavanigar Puram, anburajandoctor@
Palayamkotta - 627 002 gmail.com
156 Tamil Nadu Modern Karur A 15/2 11th Cross Street, R. Thirumal@ 93676 20313
Educational 1st Floor, Rajanmessscuddalore@ 94424 40747
Social Service Sengunthapuram, yahoo.co.in
Society (MESSS) Karur - 2
158 Tamil Nadu James Memorial Kanniakumari A James Memorial G. Frederick Raja Sekhar
Charitable Trust Charitable Trust, 9443326327
Colachel Post, gmrsekhar@gmail.com
Kannyakumari
District - 629 251.
159 Tamil Nadu Centre for Kanniakumari A Centre for Human chardep_98@yahoo.com G. Manikandan
Human Resource Resource and Rural 9942979160
and Rural Developmental
Developmental Programmes (CHARDEP),
Programmes No. 21B, Sargunaveedi,
(CHARDEP) Cross Street,
Ramavarmapuram,
Nagercoil - 1,
Kanyakumari District
160 Tamil Nadu The Modern Cuddalore A The Modern Educational R. Thirumal @ Rajan 93676 20313
Educational & & Social Service Society messscuddalore@ 94424 40747
Social Service (MESSS), No. 10, yahoo.co.in
Society (MESSS) Srinivasa Pillai Street,
Pudupalayam,
Cuddalore - 1
161 Tamil Nadu Doctor Typhagne Salem A Doctor Typhagne dtmctrust@gamil.com A. John Paul,
Memorial Memorial Charitable dtmctrust@yahoo.co.uk 9894137826
Charitable (DTMC) Trust, SMMI Sr. Francina,
(DTMC) Trust Convent Staff Quarters 9443221482
Arisipalayam,
Salem - 636 009
162 Mizoram Joy Adventist Aizwal A Seventh Day Tlang, Dr. Eileen (94361-43503), (0389) 234-0326,
Aizawl Cathy Lalnunpuii 94361-97768
aadhos@gmail.com (98630-42694)
163 Mizoram Presbytarian Duruthalang A Presbytarian Hospital, Dr. Sanghluna (0389) 236-1222,
Hospital Dururthlang 0-94361-41739
164 Jharkhand Snehdeep, Hazaribag C Snehdeep Holy Dr. Sandeep Mukerjee
Hazaribagh Cross CCC, Sitagarh,
Hazaribagh
165 Jharkhand Ashadeep, Ranchi C Ashadeep CCC,
Ranchi Hefag Hatia, Ranchi
166 Himanchal Swami Sri Chamba C Swami Shri Hari Giri
Pradesh Harigiri Hospital Hospital Cum Research
and CCC, Centre, Kakira,
Chamba Distt. Chamba
167 Punjab Community Care Amritsar C Inside Guru Nanak Ph. 0183-2572401
Center for people Dev Hospital, Near
living with De-Addiction Centre,
HIV/AIDS, Majitha Road,
Amritsar Amritsar - 143001
168 Punjab Community Care Patiala C Information not received
Center Patiala
169 Punjab Community Care Kapurthala C Information not received
Center Jalandhar,
Kapurthala
170 Kerela St Johns Health Trivandrum C St Johns Health Services Fr Jose Kizhakkedath 0472 2872047
Services Pirappancode, Trivandrum,
0472-2872047
171 Kerela Amrita Kripa Trivandrum C Amrita Kripa Sagar Care Br Amarnath 9447090075
Sagar Care Centre, Nedumangad,
Centre Trivandrum,
Phone: 0472 2891237
173 Kerela Asha Kiran, Kottayam C Pampady, Ms Isha Jacob 0482 2500431
Pampady, Near Near KG College,
KG College Kottayam - 686502
Kottayam 686502
0481 2500431
174 Kerala Nazarath Care Palakkad C Narareth Sabs Centenary srtessinmynatty@ 0491-2910035
and support Charitable Trust, gmail.com
Center Kinasery PO,
Muthukad - 678707
176 Assam Borukha Public Guwahati B guwahati@bpwt.org Mr. Ratul Kalita, 98642-16627,
Trust, Guwahati Dr. J.N. Bhattacharya 0361-223-1104,
0361-223-4104
178 Assam Astha CCC Dibrugarh C Chiring Chapori, Ranjita Tayeng Dr. H Das
Opposite Bhattacharjee 03732316917,
Press, Behnid Assam 03732310060,
Tribune, 9435112933
Dibrugarh-786001
179 Goa CARITAS Goa A Near Church Cavelossim, Sr. Vinita Joseph 0832-2871745
Salcete, Goa - 403802
180 Goa Freedom Goa A 105/A-2, Opp. Hotel Ms. Zinya DSouza 0832-2264262
Foundation Green Park, Sorvem,
Guirim, Bardez,
Goa 403507 (North Goa)
181 Nagaland ECS Hospice Tuensang A Eleutheros Christian Dr. Panker, 0361-220127 /
Society (ECS) Tuensang, M - 09436658220 09436658220
Nagaland PO Box -51
Tel: 0361-220127
182 Nagaland HIV/AIDS Care Kohima A Naga Mothers Dr. Kekhrievilhou Nakhro 0370-2800356 /
Hospice Association (NMA) Mobile No. 09856150359 09856150359
HIV/AIDS Care Hospice
Cradle Ridge, Seithogei,
PO Box No. 160,
Kohima- 797001,
Nagaland
Tel: 0370-2800356
183 Nagaland Impur Christian Mokokchung A Impur Christian Hospital, Mr. Talitemsu, Manager 0369-2262441
Hospital, Mokokchung. M-9436408316
Mokokchung
184 Nagaland Western Sumi Dimapur A Western Sumi Community Khekiho Katy (03862)245033 (R)
Community Development Project, (Development Officer)
Development Akuvuto, P.O. Box-34, 9856544303 (M)
Project Thakhekhu
(WSCDP) Village-797112, Dimapur
Dimapur E-mail: wsbak_
development@yahoo.com
185 Uttar Pradesh Umang CCC Lucknow C Near Petrol Pump, Mr. Arif 9935859534 /
Foundation Andhe ki Chowki, 9935451159
for Social Care Hardoi Road
186 Uttar Pradesh Umang CCC Merrut C B-104, Takshila Colony, Mr. Arun Kumar (0121) 3208543
Adarsh Sewa Garh Road, Meerut
Samaiti
187 Uttar Pradesh Umang CCC Varanasi C Umang Community Care Ms. Kanchana Singh 09415223387,
Centre for Social Centre, Plot No.17, 09336747468
Research Sukhi Sansar Colony,
Giri Extention,
Mahmoorganj,
Varanasi
188 Uttar Pradesh Umang CCC Gorakhpur C C-362, Raptinagar, Mr. Arvind Kumar 0551-2506064
Gramin Seva Phase-4, P.O.
Sansthan Charaganva,
Gorakhpur
189 Uttar Pradesh Umang CCC Allahabad A 21 Shivpur, Mr. Manoj Kumar 0532-232845
Society for P.O. Dhoomanganj,
Welfare & Allahabad 211010
Advancement of
Rural
Generations
(SWARG)
192 Rajasthan SAMBAL CCC Ajmer B Swasti B-88, Sarswati Mr. Bhanwer Govind 0145-2600415,
Bal Sansar Marg, Bajaj Nagar, Singh 09461478052
Jaipur
193 Rajasthan Jeevan Prakash Bikaner D Basadi-Boroda, Ms. Nisha Seezo 0151-2110285
CCC Gramin Post Udawala,
Vikas Evam via Sainthal,
Paryavaran District Dausa,
Sanstha Rajasthan
194 Rajasthan Seva Mandir Udaipur B Old Fatehpura, Ms. Ratan Paliwal 0294-2451041,
CCC Seva Udaipur- 313004, 2450960
Mandir Rajasthan
196 Rajasthan Jeevan Anand Jodhpur C 776/17 E, Housing Board Mr. Kuldeep Chaudhary 0291 2707498
CCC St. William Chopashni, Jodhpur
Educational and
Social Welfare
Society
197 Gujarat Karuna Shakti Ahmerdabad B Karuna Shakti CCC, Sr. Elizabeth 079-22861216/49 &
CCC Kaira Matikhan Talawadi, 079-65442593
Social Service Ramol Gatrad Road,
Society Nr. Toll-tax Bridge,
Ring Road, Ahmedabad
ksss@gmail.com,
Karunasccc@gmail.com
198 Gujarat Navjeevan Trust Rajkot B Jamnagar Road, Fr. C.C. Jose CMI 0281-2490916
CCC Opp. Morbi House,
Post Box No. 36,
Rajkot, Gujarat
199 Gujarat Navjeevan CCC Bhavnagar B Our Lady Pillar Sr. Dr. Scholastica (0278) 2573559
Navjeevan Disceinsary, Plot No. Macwan
Welfare Society 428/F, Prabhudas Talav,
Ruvapari Road,
Bhavnagar
200 Gujarat Sphoorti Mehsana B Sabarmati Sammrudhi Ms. Hemlata (079) 23227856
Sabarmati Seva Sangh,
Samruddhi C/o Catholic Ashram,
Seva Sangh Post Box No.3,
Ramosana Road,
Mehshana - 384002
201 Gujarat Jeevan Jyoti Vadodara B Jeevan Jyot CCC, Ms. Susan (0265) 5596970
Kripa Foundation C/O Kripa Rehabilitation
Centre,At & Post Amodar,
Taluka-Vaghodiya,
Vadoara - 390019
204 Chattisgarh Lifeline CCC Bastar C C/o MPM Hospital, Fr. K.T. Thomas 07782 229030,
Model Bastar Aghanpur, Jagdalpur, 229032
Integrated Rural Bastar DT.,
Development Chhattisgarh - 494005
Society (BIRDS)
205 Chattisgarh Holy Cross Sarguja C Holy Cross CCC, Sr. Juliet Jacob (+91-79363660)
Pavitra Cruz Holy Cross Hospital, (+91-9425255922)
Sisters Society Ambikapur,
DistrictSarguja,
Chattisgarh - 497001
206 Chattisgarh Karuna CCC Durg A Karuna CCC, Karuna Sr. Sushila 0788 - 2296486;
Hospital, Nandini Road, 9752898960
Khurispar, Bhillai,
Durg - 490002
207 Chattisgarh Maria Sahay Bilaspur C Maria Sahaya CCC, Sr. Kusum 0775 -22733673;
CCC Sipat Road, Sarkanda, 98983396495
Bilaspur - 495006
208 Chattisgarh Jeevodaya CCC Raipur C Jeevodaya CCC, Social Fr. Abraham 0771 2120131
Jeevodaya Social & Leprosy Rehabilitation Thylammanal SAC
& Leprosy Center, P.O. Abhanpur,
Rehabilitation Dt. Raipur,
Center Chattisgarh - 493661
209 Madhya Pradesh Saathi CCC Ujjain C MIG A 5/16 Mahakal 0734-2533246
Kripa Social Vanijyik Kendra,
Welfare Society Ujjain - 456010
210 Madhya Pradesh Asha Kiran Jabalpur C M-54, 7th Lane, Avinash Pillai 9425873616
Jabalpur Behind Gupta Hotel,
Diocesan for Sharda Colony,
Social Service Shakti Nagar, Jabalpur
Society
211 Madhya Pradesh Maitri Asha Bhopal B Gandhi Bhavan, Mr. Shaji Chacko 0755-4273848
Niketan Shyamla Hills
212 Madhya Pradesh Vishwas CCC Indore B R-847, Near Poineer Sr. Geeta 0731-2556372
Pavitra Atma Convent, Mahalaxmi
Sevika Sangh Nagar, Indore
213 West Bengal Arunima CNI Kolkatta A 81, Diamond Harbour Mr. Suvobrata Das (033) 6450 8840
Calcutta Road, Barisha,
Diocesan Kolkata - 700 008
Central Fund
214 West Bengal Snehalaya Midnapur B Vill - Dihibaliharpur, Mr. Badal Maharana 03225-254217
Gandhi Mission Post - Daspur,
Trust Dist - Paschim Medinipur,
West Bengal - 721211,
India
215 West Bengal Sparsha Howrah C Vill. - Majerati, Banitabla, Mr. Surja Kanta Ghosh 33 2661 1815
SPARSHA P.O. Jadurberi,
P.S. Uluberia, Howrah
216 West Bengal Jeshu Ashram Siliguri Vill Matigara, Mr. Ratan Lama 3536453470
Jesu Ashram P.O. Matigara,
Dist Darjeeling,
West Bengal
217 West Bengal Chetna CCC Bardwan A Jhinguti, P.O.- Phagupur, Mr. Rahul Sonkar 9832713315
Asansol Burdwan Burdwan
Seva Kendra
218 West Bengal Sewa Kendra Kolkatta A Seva Kendra, Community Mukul Haldar (033) 30239384
Sewa Kendra Care Centre, Seva
Kolkotta Kendra, Calcutta
Extension, Dum Sum,
93, P.K. Guha Road,
Kumarpara,
Dum Dum Cantonment,
Kolkata 700 028
219 West Bengal ASHAAR ALO Malda C P.O. - Phulbari, Mr. Selestion Minz 03512-340900
CCC Social Manaskamana Road,
Welfare Institute Dist. Malda - 732101,
West Bengal
220 West Bengal Bhalobasha, Jalpaiguri B Bhoruka Bhalobasha, Tamali Dutta 9733263805
Bhoruka C/o Mr. Sushil Chandra,
Farm More, Mohit Nagar,
Post - Jalpaiguri-735101
221 West Bengal Anugalaya CCC Darjeeling Hills B 4, Mall Villa., Mr. Albert Rai 9749091420
Anugyalaya C.R. Das Road,
DDSSS Darjeeling - 734101
222 Bihar Nai Asha Mokama C Nazareth Hospital, Sr. Nirmala Mulackal 06132232367 /
Nazareth CCC, Mokama P.O., 233014
Mokama Patna Dist., Bihar
Nazareth
Hospital Society
223 Bihar Holy Family, Bhagalpur C The Poreyahat Holy Sr. Grace
Bhagalpur Holy Family Society,
Family, Bhagalpur Holy Family Convent,
Tilakmanjhi, Bhagalpur,
Bihar - 812001
224 Bihar Sanjeevani Darbhanga C Sanjeevini Community Er. Kaushendra Sanjay (+91-9308004404)
Sanjeevani Care Centre, Kumar
Darbhanga Hospital Road, Beta,
P.O. Leheriasaria,
Dist. - Darbanga, Bihar
225 Bihar Jeevan Sagar Muzaffarpur C Fakirana Sisters Society, Sr. Mary Elise 0621-2280196
Fakirana Sisters Sacred Heart Convent,
Society Bettiah, District West
Champaran, Bihar
226 Bihar Navjeevan Kurji Patna C Kurji Holy Family Sr. Francina 0612-2262156
Holy Family Hospital, Bihar - 800010
Hospital
227 Orissa Ashray LEPRA Koraput B Behind Collectorate, Mr. Rajendra Chowdhury 06658-252352
Society Hati Line, Koraput,
Orissa
228 Orissa SATHI TSRDS Ganjam A At/Po- Bahadurpeta, Dr. P.C. Mahapatra 0657-2425999
(On the way to
Gopalpur-on-Sea)
Via- Bhanjabihar, Ganjam
229 Orissa Astha CCC Khurda B Near Kalinga Vihar Dr. Dilip Kumar Pradhan 06764-234075;
The Medics Phandi, Kalinga Vihar 09437018075
Phase II, Plot No.
HIG-358, Patrapada,
Bhubaneswar-19
230 Orissa Kiran CCC Utkal Cuttack C Plot No. 191, Mahanadi Mr. Amiya Bhusan Biswal 0671-2444984
Sevak Samaj Vihar, Nayabazar,
Cuttack, Orissa-753004
0671-2444984
ussngo@sify.com
231 Orissa Jyothi CCC Balasore NA Jyoti CCC, Pretheep Jose/ Fr. Paul 06782 - 256173
Post - Kuruda,
Balasore - 756054
232 Tripura Hepititis Agartala, A Anandlok, Indra Nagar, Shri Snehangshu 3812321166
Foundation of West Tripura Agartala, Tripura West Sekhar Dutta,
Tripura, Agartala 9436463337
233 Tripura Udaipur Bignan South Tripura B Aaswas, Shri Jaglul Ahsan, 0381-223117,
O Sanskriti Nehru Supermarket, 9436521882 09856140969
Mancha, Udaipur House No. 47/48,
Udaipur, South Tripura
234 Pondicherry Shanti Bhavan Pondicherry B
Remember these are more fun when the trainers join in!
2. SPACE ON MY RIGHT:
Participants are seated in a circle. The facilitator arranges for the space on their right to remain empty. They
then ask a member of the group to come and sit in the empty space; for example, I would like Lili to come
and sit on my right. Lili moves and there is now a space on the right of another participant. The participant
who is sitting next to the empty space calls the name of someone different to sit on his or her right. Continue
until the entire group has moved once.
5. BODY WRITIING:
15 Body writing Ask participants to write their name in the air with a part of their body. They may choose
to use an elbow, for example, or a leg. Continue in this way, until everyone has written his or her name
with several body parts.
7. SIMON SAYS :
The facilitator tells the group that they should follow instructions when the facilitator starts the instruction
by saying Simon says... If the facilitator does not begin the instructions with the words Simon says, then
the group should not follow the instructions! The facilitator begins by saying something like Simon says
clap your hands while clapping their hands. The participants follow. The facilitator speeds up the actions,
always saying Simon says first. After a short while, the Simon says is omitted.
Steps:
Ask for a participant to volunteer, without telling the purpose of the game ( Volunteer should trust the
Trainer).
Take her out of the room and blindfold her.
In the meantime, come back and ask the other participants to rearrange the furniture in the room to
create enough space and to make the game more interesting.
Bring the volunteer back in the room, make her feel the treasure and put it at some accessible location
in the room.
Instruct her to hunt for it in the room.
Do not give any explicit instructions to the volunteer or the group on whether she can seek the help
from the group or whether the group can guide her.
Make sure that the volunteer does not hurt herself while hunting for the treasure; If you observe that
the volunteer is finding it difficult to locate the treasure ,keep it at a more convenient location.
Observe the group behavior ie whether they remain silent or assist the volunteer in locating the treasure
(by providing her appropriate directions) - both while you are present in the room or when you move
out; do they wait for instructions from you to guide the volunteer or do they themselves take the
initiative.
Ultimately, when the volunteer is able to successfully hunt for treasure, congratulate her on her efforts
and remove the blindfold.
Process:
Make the group count 1,2,1,2
Divide all the 1s and 2s in two groups and pair them
SAMPLE ENERGIZERS:
The following can be carried out to music, with brief stops in the music to signal that the movement/role
should change.
Divide the participants into pairs, one person in the front and the other person behind. Get the person
at the back to rub the shoulders of the person in front. The pair turns around and exchange roles.
Get participants of the same size and preferably same gender, to stand back to back. Each person
drops her/his head on the other persons shoulder and relaxes.
Participants can form a semi-circle with the person at the far end bending forwards from the waist,
hands forward and inhaling, and exhaling while coming up, everyone follows suit.
Everyone does spot jogging while facing her/his partner.
Get a small group to stand on either side of a person. The person in the middle gets gently pushed
from one group to another. The person in the middle should not resist or move voluntarily, but just relax
and let others take care of her/him.
Pre ART No. or ART Registration No. __ __ __ __ __ __ __ __ __ __ ART Registration Number : __ __/__ __/__ __/__ __ __ __
ID No. as per child health card __ __ __ __ __ __ __ __ __ __ Date of start of ART : __ __/__ __/__ __/__ __ __ __
Risk 1 Heterosexual
Factor 2 MSM
HIV 3 Injecting drug use (IDU)
4 Blood transfusion
5 Mother to child
6 Probable unsafe injection
7 Unknown
For IDUs Substitution therapy Y N
If yes, type:
Education: Non-literate
Primary school _________________________
Secondary school
College & above
Employed: Yes No Occupation: ___________
Instruction: Sections 1-3 to be filled by Counsellor. Sections 4-13 by Physician/Doctor.
* TG/TS Transgender/Transexual ** Functional status: W Working = able to perform usual work in or out of the house, harvest, go to school or, for children, normal
activities or playing A Ambulatory = Able to perform activities of daily living but not able to work B Bedridden = Not able to perform activities of daily living.
National AIDS Control Organization (NACO), Ministry of Health and Family Welfare, Government of India, February 2007
Were ARVs received ? Initial CD4 count No. _____ % ____ Place of ART: Private Govt NGO
Yes No
Drugs and duration:
If yes, PMTCT ART
PEP
Treatment Started SUBSTITUTION within 1st line, SWITCH to 2nd line, STOP, RESTART
STV + LMV + NVP Date Substitution, Reason Date New
STV + LMV + EFV switch or stop (code) restart regimen
ZDV + LMV + NVP
ZDV + LMV + EFV
Others : __________
_________________
Transferred out Date last visit: ____/____/______ New ART centre name: _________
Coexisting conditions :
Contraception :
1. Condoms 2. Oral contraceptives 3. IUD 4. Tubal ligation 5. Vasectomy 6. None
GYNECOLOGICAL HISTORY
G ______ P ______ A ______ Last Menstrual Period: ____ day ____ month ______ year
Other Remarks :
Sex : Male Female Age: ________years Date of birth: ___ day ____month ____ year
Others _____________________________________________________________
Immunization Record
Age Vaccine Due on Given on Age Vaccine Due on Given on
BCG 15-18 MMR
Birth OPV 1 months DPT 1 booster
HBV 1 OPV 6
14 weeks DPT 3
OPV 4
9 months Measles
& Vit. A
Test \ date // // // // // // // // // // // //
Hb
TLC
DLC
ESR
PLT
Essential Laboratory: blood, serology, urine
MCV
S. Creatinine
S. Bilirubin
Blood Urea
SGOT
Amylase
Blood Sugar
Cholesterol
Triglycerides
VDRL
HBsAg
Anti-HCV
CD4 count/CD4 %
Viral Load
Additional
labs.
Pap smear
Mantoux Test
CXR (PA view) Date & Finding: Date & Finding: Date & Finding: Date & Finding:
Others (Imaging,
culture, etc.)
Date & Finding: Date & Finding: Date & Finding: Date & Finding:
Date & Finding: Date & Finding: Date & Finding: Date & Finding:
Date & Finding: Date & Finding: Date & Finding: Date & Finding:
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19
Sl. Date Date Weight Height Func- WHO Oppot- Drugs prescribed for Anti- Adher to Any TB ART Con- Preg- Condoms Remarks/ Staff
No. of of (kg) (cm) tional Clinical tunistic Opportunistic Infections retroviral ART## other treatment Side current nancy given Referrals Signature
visit* next of Status Stage Infections Prophylaxis (Dosage) Rx drugs (No. of medicine Y / N effects condition (y / n) Y/N
visit child WAB** (code)* CTX Other and dose doses code$ e.g. STI of FP
prescribed missed) method***
10
11
12
13
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19
Sl. Date Date Weight Height Func- WHO Oppot- Drugs prescribed for Anti- Adher to Any TB ART Con- Preg- Condoms Remarks/ Staff
No. of of (kg) (cm) tional Clinical tunistic Opportunistic Infections retroviral ART## other treatment Side current nancy given Referrals Signature
visit* next of Status Stage Infections Prophylaxis (Dosage) Rx drugs (No. of medicine Y / N effects condition (y / n) Y/N
visit child WAB** (code)* CTX Other and dose doses code$ e.g. STI of FP
prescribed missed) method***
14
15
16
17
18
19
20
21
22
23
24
25
26
Note: You can check your own progress in counselling clients at the clinic
Note to counsellor: Confidentiality of the client information should be strictly maintained at all times.
1. Date: ___ /___ /___ 2. Time: (start of session): _________
3. PID number: ________ 4. ICTC code___________________
5. Age: ___ years 6. Sex: M / F / Transgender
7. Education: standard: illiterate/1.5/6.8/8.10/11.12/Graduate/Post-graduate
8. Occupation: ________ (Migrant/ Non-migrant)
9. Monthly income in Rs: 0.2,500/2,501.5,000/5001.7,000/7,001.10,000/ more than 10,000
10. Marital status: unmarried/ married/widowed/divorced/separated/living together
11. Referred by: Self/Doctor/NGO/CBO/Spouse/Family/Friends/Others ______
12. Medical history: (Does your client currently have any medical problems or symptoms?]
Nil/Recurrent fever/weight loss/cough/diarrhoea/STIs/TB/OIs/Others ______
13. Currently on treatment: ______
14. Tested before for HIV: How many times? ___ Last test (month/year): ___ /___
Where (Place): ___________________________ Result: _________________
The form is to be filled in AFTER the counselling session with whatever information was discussed.
Counsellor instruction: Please explore the following issues with your client:
15. Risk assessment of the past six months: (perception of risk to self)
Q: Why has the client presented for counselling and testing?
__________________________________________________________________________________
__________________________________________________________________________________
Q: Why does your client think he/she is at risk of HIV?
__________________________________________________________________________________
__________________________________________________________________________________
(a) No risk (b) Perinatal (from mother to child)
(c) Contaminated blood through:
Blood transfusion .IDU
Organ transplant .Tattoo
Needle stick injury
(d) Unprotected sex:___ Vaginal___ Anal
(e) Partner or family member infected
__________________________________________________________________________________
16. Development of a risk reduction plan
(a) Increase condom use (b) Reduce number of sexual partners
(c) Reduce needle sharing (d) Reduce alcohol or drug use
(e) Discussion with spouse/partner (f) Others
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
What plans does your client have for managing the crisis associated with HIV/AIDS?
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
Note to counsellor: Confidentiality of the client information should be strictly maintained at all times.
The form is to be filled in AFTER the counselling session with whatever information was discussed
Use assessment format given below for assessing the clients risk for suicide.
Note: The suicide risk assessment provides a guideline for professionals on how to interview persons at risk
for suicide. As guidelines rather than a ready-to-use questionnaire, many questions would need more
exploration and probing in order to evaluate the subjective reality of each individual at risk.
1. Do you sometimes feel so bad/hopeless/helpless you think about suicide? YES /NO
Follow this up with the following explorations:
2. How often?
a. Are you currently thinking of suicide? YES / NO
b. Have you thought of how would you do it? YES / NO
3. Do you have a plan? YES / NO
a. How lethal is the planned method?
(EXPLORE the perception of the person at risk!)
Write down the clients answer. Generally, any positive change perceived by the Client makes the risk
higher.