World AIDS Day is observed annually on December 1 to raise global awareness on HIV/AIDS, honour those who died from HIV-related illnesses, and reaffirm support for People Living with HIV (PLHIV).

What is HIV/AIDS?

• Definition: HIV (Human Immunodeficiency Virus) is a virus that weakens the immune system by attacking CD4 cells, which are essential for defending the body against infections.
  • Over time, HIV weakens immunity, making the person vulnerable to opportunistic infections.
• Progression to AIDS: 
  • AIDS (Acquired Immunodeficiency Syndrome) is the most advanced stage of HIV infection.
  • It occurs when the immune system becomes severely damaged and CD4 count falls below 200 cells/mm³, or when the person develops serious opportunistic diseases (e.g., TB, cancers).
  • Transmission of HIV:
  • Sexual Transmission: HIV spreads through unprotected sexual contact with an infected individual.
  • Transmission Through Needles: Sharing contaminated needles or syringes is a major source of HIV transmission.
  • Mother-to-Child Transmission: The virus can pass from mother to child during pregnancy, childbirth, or breastfeeding.
  • Blood Transfusion Risk: Transfusion of infected blood can spread HIV, although this has become extremely rare due to strict screening systems.
  • HIV does NOT spread through casual contact like touching, hugging, food sharing, mosquito bites, or air.
• Treatment: 
  • Although there is no cure for HIV, Antiretroviral Therapy (ART) effectively controls the virus.
  • ART must be taken daily and lifelong to maintain immune function and prevent progression to AIDS.

India’s HIV/AIDS Response and Historical Journey

• Early National Efforts (1985–1991): India’s initial phase focused on identifying HIV cases, ensuring safe blood transfusions, and launching targeted public awareness initiatives.
• Institutional Framework: Establishment of the National AIDS Control Organisation (NACO) and National AIDS Control Programme (NACP) in 1992 under the Ministry of Health created a coordinated, multisectoral national response.
  • Over time, the response shifted from centralised control toward district-level engagement, NGO participation, and stronger PLHIV networks.

National AIDS Control Programme (NACP)

• Evolution: NACP has progressed through five phases, moving from basic awareness efforts to a comprehensive prevention–testing–treatment model.

NACP I (1992–1999)

• This phase marked India’s first nationwide HIV/AIDS prevention strategy.
• The main aim was to slow HIV transmission and reduce resulting morbidity, mortality, and socio-economic impact.

NACP II (1999–2006)

• The programme expanded its focus and strengthened earlier interventions.
• Focused on two key objectives:
  • Reduce the spread of HIV in India.
  • Strengthen long-term national capacity to respond to HIV/AIDS.

NACP III (2007–2012)

• Goal: Aimed at halting and reversing the HIV epidemic over a five-year period through expanded prevention, care, and treatment strategies.
• Key Addition: District AIDS Prevention and Control Units (DAPCUs) were established to strengthen district-level monitoring and address stigma and discrimination.

NACP IV (2012–2017)

• Goal: The goal was to accelerate epidemic reversal and deliver an integrated HIV response.
• Major Objectives: 
• • Achieve a 50% reduction in new infections (compared to 2007).
  • Ensure universal access to care, support, and treatment for all PLHIV.

Extension (2017–2021): Extended to advance the goal of Ending AIDS by 2030.

Key Initiatives During Extension are

• HIV/AIDS Act 2017:  The HIV/AIDS (Prevention and Control) Act, 2017 prohibited discrimination, protected confidentiality, and mandated informed consent for testing and treatment.
• Mission Sampark: This mission worked to trace and re-engage PLHIV who had discontinued ART.
• Test and Treat Policy: ART began for all diagnosed individuals, regardless of their CD4 count.
• Viral Load Monitoring: Routine universal viral load testing was implemented to improve treatment adherence and outcomes.

NACP V (2021–2026)

• Type: Implemented as a Central Sector Scheme with a financial outlay of ₹15,471.94 crore.
• Key Focus: Aims to consolidate earlier achievements while tackling emerging challenges in prevention, testing, and treatment.
• Alignment with SDGs: This Phase supports SDG 3.3, targeting the end of HIV/AIDS as a public health threat by 2030, with a focus on community-led interventions. 

Government Steps for HIV/AIDS Awareness

• Mass Media Campaigns: NACO conducts extensive multimedia and digital campaigns to reach broader and younger populations.
• Outdoor Awareness Initiatives: Outreach is expanded using hoardings, bus panels, IEC vans, kiosks, and folk performances.
• Community Mobilisation: Training of SHGs, Anganwadi Workers, ASHAs, and Panchayati Raj representatives helps strengthen awareness at the grassroots level.
• Targeted Intervention Projects: As of October 2025, there are 1,587 Targeted Intervention (TI) projects ensuring prevention, testing, and treatment services for HRGs.
• Anti-Stigma Campaigns: Nationwide thematic campaigns work to reduce stigma and promote inclusion of PLHIV in workplaces and institutions.
• Legal Protection Mechanisms: Ombudsmen have been appointed in 34 States/UTs under the HIV and AIDS Act, 2017 to address discrimination complaints and safeguard PLHIV rights.

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