National AIDS and STD Control Programme (NACP-V)

The National AIDS and STD Control Programme is now in its fifth phase, NACP-V, running from 2021-22 to 2025-26. Its operational backbone is the National AIDS Control Organisation, working through State AIDS Control Societies and a network of over seven hundred ART centres, twelve hundred Link ART Centres for last-mile drug dispensing, and more than thirty-five thousand testing facilities at primary health centres, community health centres and district hospitals.

The non-negotiable guarantee is this: any person diagnosed HIV-positive in India is entitled to free, lifelong antiretroviral therapy from the date of diagnosis. The Test-and-Treat policy adopted in 2017 abolished the older CD4-count threshold for starting treatment. There is no income test, no citizenship paperwork required at the point of starting therapy, and no co-payment at any stage.

Testing is offered free at every Integrated Counselling and Testing Centre and at all PPTCT centres for pregnant women. The test is confidential by law; the counsellor cannot share the result with family, employer, school, or any other person without the patient's written informed consent. The HIV and AIDS (Prevention and Control) Act, 2017 makes this duty enforceable.

Once a positive diagnosis is confirmed, the patient is referred to the nearest ART centre, registered, issued a unique PLHIV ID, and started on the standard first-line regimen, currently a fixed-dose combination of tenofovir, lamivudine and dolutegravir for most adults. Drug refills are monthly at the ART centre, but patients living far from the centre may collect their medication at a Link ART Centre closer to home, after the first six months of stable treatment.

The HIV and AIDS (Prevention and Control) Act, 2017 prohibits discrimination against people living with HIV in employment, healthcare, education, housing, insurance, and access to public office. Any breach is a civil wrong with statutory compensation, and the Act provides for an HIV Ombudsman in every state to receive and resolve complaints within a defined time-frame.

If a hospital refuses surgery, a school denies admission, an employer terminates service, or a landlord evicts on grounds of HIV status, the survivor can approach the State HIV Ombudsman directly. The complaint procedure is non-adversarial and free. For breach of confidentiality by a health worker, an additional complaint to the State Medical Council or to the police under Section 23 of the Act is available. In our field experience, the single biggest barrier remains awareness of the Act, not its enforceability.

• 01Any Indian citizen testing HIV-positive is eligible for free lifelong ART from the date of diagnosis, regardless of CD4 count, income or location
• 02Pregnant women living with HIV are eligible for the PPTCT (Prevention of Parent-to-Child Transmission) protocol at any government health facility
• 03Children of HIV-positive parents are eligible for free Early Infant Diagnosis (EID) and paediatric ART formulations
• 04Key populations — sex workers, men who have sex with men, transgender persons, people who inject drugs — are eligible for targeted prevention services through Targeted Intervention NGOs

• §No documents are required for HIV testing at an ICTC; the service is fully confidential
• §PLHIV ID card is issued by the ART centre at registration; this is the only document needed for treatment continuity
• §Aadhaar is voluntary and cannot be made mandatory under the HIV Act of 2017
• §Pregnancy registration card for PPTCT enrolment, where available

• ART centre demands Aadhaar before issuing medication — this is unlawful under the HIV Act
• Patient relocates but does not request a Transfer-Out form, leading to a gap in records
• Self-discontinuation during travel, after which restart requires repeat baseline tests
• Confidentiality breach by the facility, which is a punishable offence and grounds for complaint to the State HIV Ombudsman

• NACP-V Strategic Plan 2021-26, National AIDS Control Organisationlink ↗
• HIV and AIDS (Prevention and Control) Act, 2017, Ministry of Law and Justice
• National Operational Guidelines for ART Services (2023), National AIDS Control Organisation