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West Bengal is a state in the eastern region of India and is the nation’s fourth-most populous. It is particularly vulnerable to HIV infection, with the vulnerability issue varying from one district to another.
In the districts, there are variations with varying levels of risk of acquiring and spreading the infection. Though predominantly the route of transmission is sexual, one finds that there are certain districts like Kolkata and Darjeeling, besides the sexual route, the epidemic is also driven by the injecting route of transmission. In West Bengal, the 2010-11 HSS round found an HIV prevalence of 2.72% among IDUs, 5.09% among MSMs, 2.04% among FSWs and 0.13% among pregnant women. If compared to the previous year’s figures in 2008-09 (6.90% among IDUs, 4.90% among MSM and 4.12% among FSWs and 0.21% among pregnant women), HSS 2010-11 results suggest that the trend in the epidemic continues; it is concentrated mainly in the high risk groups.
To control the spread of HIV/AIDS in the state, interventions known as targeted interventions (TIs) are being implemented among the high risk groups (HRGs) and vulnerable populations in West Bengal. Interventions among the HRGs like female sex workers, injecting drug users, transgenders, hijra and men who have sex with men and vulnerable populations like migrant labourers and truckers include (i) the provision of behaviour change interventions to increase safer practices, testing, counseling, adherence to treatment and demand for other services (ii) the promotion and provision of condoms to HRGs (iii) provision or referral for STI services including counselling at service provision centres to increase compliance to treatment, risk reduction counselling with focus on partner referral and management; (iv) needle and syringe exchange for IDUs as well as provision of Opioid Substitution Therapy (OST).
Overall a total of 37 TI projects are operational in the state of West Bengal in 15 out of the 20 districts of the state. The spread of TIs across these 15 districts are as follows:
| Sl No | Districts | No of TIs |
|---|---|---|
| 1 | Kolkata | 6 |
| 2 | S 24 Parganas | 4 |
| 3 | Burdwan | 5 |
| 4 | Birbhum | 1 |
| 5 | Purba Medinipur | 1 |
| 6 (a) | Darjeeling hills | 2 |
| 6 (b) | Darjeeling plains | 3 |
| 7 | DJalpaiguri | 1 |
| 8 | Hooghly | 2 |
| 9 | Nadia | 1 |
| 10 | Howrah | 3 |
| 11 | N 24 Parganas | 4 |
| 12 | Malda | 1 |
| 13 | Murshidabad | 1 |
| 14 | Uttar Dinajpur | 1 |
| 15 | Coochbehar | 1 |
| Total | 37 | |
Typology wise number of existing TIs along with coverage as of 31st March 2015 is as follows:
| Typology | Actual No. of TIs as on 1st April 15 | Actual Coverage |
|---|---|---|
| FSW | 19 | 28,541 |
| TG/Hizra | 01 | 325 |
| MSM | 04 | 1200 |
| IDU | 03 | 2,011 |
| Core Composite | 01 | 200 FSW 100 MSM |
| Migrants | 03 | 30,000 |
| Truckers | 06 | 60,000 |
| Total | 37 | |
In addition to the above, the number of existing Source Migrant and Transit Migrant interventions in the State are:
| Intervention Type | Nos. | |
|---|---|---|
| Transit Migrant | 10 | |
| Source Migrant | 05 | |
During the period 1st April 2014 to 31st March 2015, 12 OST centres were functional in the state. Out of the 12 centres, 11 were NGO run while the remaining 1 was run by a Government health facility in Murshidabad. The 12 OST centres are spread across Darjeeling – 9 (5 in the hills and 4 in plains), Murshidabad – 1, Kolkata – 1 & Howrah – 1, districts. All the 12 centres are implementing Buprenorphine maintenance program. Of the 11 centres that were NGO run 7 are temporary in nature and are being replaced by centres at Govt. health facilities. The remaining 5 centres are run within IDU TIs from 1st April, 2015 only one OST Centre will be in the NGO, i.e., The Calcutta Samaritans, Howrah. The rest will be transferred to government health facilities.
The 12 OST centres in both NGO and Govt. health facilities and their allotted slots are-
| Sl No. | Name of OST Centre | Slots |
|---|---|---|
| 1 | GUP, Siliguri | 50 |
| 2 | GUP, Naxalbari | 25 |
| 3 | BPWT, Gurung Basti | 50 |
| 4 | BPWT, Uttar Ektiasal | 80 |
| 5 | D.B. Giri Road, SPYM, Darjeeling | 50 |
| 6 | D.B. Giri Road, SPYM, Ghoom | 30 |
| 7 | D.B. Giri Road, SPYM, Mirik | 30 |
| 8 | D.B. Giri Road, SPYM, Kurseong | 30 |
| 9 | D.B. Giri Road, SPYM, Kalimpong | 50 |
| 10 | The Calcutta Samaritans, Howrah | 80 |
| 11 | The Calcutta Samaritans, Kolkata | 120 |
| Total Slots | 645 | |
| Sl.No. | Name of OST Centre | |
|---|---|---|
| 1 | Calcutta National MC&H, Kolkata | |
| 2 | North Bengal MC&H, Darjeeling | |
| 3 | Darjeeling DH, Darjeeling | |
| 4 | Kalimpong SDH, Darjeeling | |
| 5 | Kurseong SDH, Darjeeling | |
| 6 | Mirik BPHC, Darjeeling | |
| 7 | Murshidabad MC&H (existing with 50 slots) | |
The National AIDS Control Organization contracted Society for Promotion of Youth & Masses (SPYM) a national level NGO to set up the Technical Support Unit (TSU) of West Bengal in late April 2014. The main purpose of the TSU is to provide technical support to SACS in specified areas for helping it to achieve the goals and objectives of NACP IV that of prevention and treatment. The TSU in West Bengal therefore became operational from 1st May 2014. Its main mandate is to build capacities and improve and strengthen the quality of targeted interventions in the state.
After becoming operational from May 2014 the TSU has tried to improve the quality of TIs through regular handholding and onsite mentoring of TIs. Overall man days have been utilised to improve performance as well as record keeping.
