Linkages Across the Continuum of HIV Services for Key Populations Affected by HIV (LINKAGES) Project Quarterly Progress Report (QPR): Field Support April 1, 2016 – June 30, 2016

Statewide workshops were conducted in Mumbai, Maharashtra, and Vijayawada, Andhra Pradesh, to introduce 63 targeted intervention nongovernmental organizations and community service organizations to the project's aims and activities. A baseline assessment was conducted in Andhra Pradesh, which confirmed high HIV testing rates but low yield in HIV positivity. Technical and managerial support was provided to two technical support units in the states of Uttar Pradesh and Uttarakhand. An expert hired under LINKAGES conducted a situation assessment of intervention programs for people who inject drugs in the two states, identifying several gaps in the program, including substantial numbers of unreached people and poor uptake and unavailability of opioid substitution therapy. Organized meetings with State AIDS Control Societies and technical support units in Maharashtra and Andhra Pradesh were held to discuss the project's aims and proposed activities, with agreements on joint activities and collaborations to avoid duplication of efforts. The project also conducted orientation workshops in Andhra Pradesh and Maharashtra for targeted intervention NGOs working in the five focus districts, covering the aims and activities to be supported under LINKAGES. The workshops were co-facilitated by State AIDS Control Societies and technical support units, with 85 and 55 participants attending the workshops in Andhra Pradesh and Maharashtra, respectively. Pre-tested mapping tools for key population size estimation activities were used in both urban and rural settings as part of the baseline assessment, with early mapping results showing some new hotspots and unreached key populations in rural areas. The project also provided technical and managerial support for two technical support units in Uttar Pradesh and Uttarakhand, with a PWID expert hired as a consultant to conduct a situational assessment and develop recommendations for intensified interventions to address the gaps in the program. The programmatic data from targeted intervention NGOs showed an HIV prevalence among people who inject drugs of about 10%, suboptimal coverage due to large numbers of unreached people, and poor uptake and unavailability of opioid substitution therapy. The draft recommendations include capacity-building of targeted intervention NGO, technical support unit, and opioid substitution therapy staff, fresh mapping of people who inject drugs, scaling up opioid substitution therapy, and ensuring availability of overdose management. The project also hired a program manager for Maharashtra, selected three organizations as lead partners, and provided logistics support for the launch of the PEPFAR unified strategy in Maharashtra and the National AIDS Control Program Phase IV Mid-Term Assessment briefing and debriefing meetings in Delhi. The project monitoring and evaluation plan and the environmental mitigation monitoring plan were finalized and submitted to USAID. The project also initiated technical assistance activities to improve access and demand for services, including segmenting key populations based on risk assessment, setting up new models of service delivery, and developing training materials for community-based HIV testing and counseling.