In accordance with recommendations of Technical Resource group on ART and review of evidence in WHO 2016 ART Guidelines, the guidelines for initiation of ART in PLHIV under National programme have been revised. As per revised guidelines, it has been decided to TREAT ALL PLHIV with Anti Retro Viral Therapy regardless of CD4 count, clinical stage, age or population.

Patients who are in Pre ART care should undergo a fresh CD4 count if it is more than three months old and baseline investigations before ART initiation as per revised criteria.

Adequate counselling and preparedness needs to be ensured before ART initiation in all PLHIV, particularly for those with higher CD4 count as they are likely to be asymptomatic and more likely to default and as a result a massive chunk of responsibility is on the shoulder of the counsellors who act as an guide to all the clients.

Further with an aim to make the medicine available to all the clients NACO ensures strict monitoring of the medicines through all the SACS CST Division, and any non availability of medicine is reported online on real time information system through IMS.

Regardless to the economic status of the client visiting the ART centre to collect their medicine are reimbursed with the transportation cost that they have spent through E transfer so that proper adherence may be achieved.