LINKAGES Quarterly Report (January 1 – March 31, 2018) – India

An acceleration plan was developed to target interventions and innovative approaches to reach and provide services to most-at-risk KP. The plan led to substantial improvements in case detection and linkages to treatment. During the reporting period (January 1 – March 31, 2018), LINKAGES India maintained an upward trend in coverage and case detection rates through scaling up implementation of innovative approaches like Enhanced Peer Outreach Approach (EPOA), piloting community-led interventions (CLI), and other strategic new approaches like peer navigation and index testing. The project newly identified 519 new HIV-positive individuals this quarter, increasing the case detection by 63% from the last quarter and achieving 44% of the annual case detection targets within the first six months of FY 2018. The project extended technical assistance to 75 Targeted Interventions (TIs) in six cluster districts to reach and provide HIV prevention services to 100,285 KP, including 70,051 female sex workers (FSWs), 22,103 men who have sex with men (MSM), 7,079 transgenders (TG), and 1,052 people who inject drugs (PWID). All 75 TIs expanded coverage by registering new and unreached KP in their designated geographical areas based on mapping exercises conducted by LINKAGES during the last two years. Overall, the TIs registered 3,428 new KP in Q2 FY18, taking the total new KP registrations in TIs in FY 2018 to 7,752 KP. The project provided HIV testing and counseling services to 38,589 KP in TIs, including 2,266 new KP registered in TIs in five of the six PEPFAR cluster districts during the quarter. Index case testing was initiated in TIs in Q1 FY 2018 and was strengthened with orientation of Peer Navigators on processes of partner notification and mobilizing spouses and partners of KP PLHIV for HIV testing. 412 individuals were provided HIV tests, with 31 new positives identified, including 8 partners who are KP. Non-TI approaches were further scaled up during the quarter, with emphasis on districts in Maharashtra. This included EPOA in 11 sites, index case testing in 3 sites, and community-led engagement with HIV/AIDS Alliance in 5 districts (except Mumbai) and three sites led by KP CBOs. Further, Community-Based HIV Testing (CBHTC) was taken up to implement test and treat approach in areas where KPs were scattered and TI services were not available. Overall, 4,721 new KP were reached and 3,385 KP were provided HIV testing in non-TI settings, with 307 new HIV-positive KP identified, for a case-detection rate of more than 9 percent of KP tested. The project is actively engaging the newly identified HIV positives for identifying and testing other KP members in their social and sexual networks. Index Case Testing initiated in last quarter was further strengthened to test spouses and partners of KPLHIV identified in non-TI approaches. 183 individuals were provided HIV tests, with 76 new positives identified, with a case detection rate of 42 percent. HIV-positive partners identified through index testing included 3 KP (2 MSM and one TG). The project reached 105,006 KP with HIV prevention services during the reporting quarter, including 100,285 KP through provision of technical assistance to 75 TIs supported by the national program and 4,721 KP through direct service delivery mode by implementing non-TI approaches. The TIs registered 3,438 new KP during the quarter, taking the total new registrations in FY 2018 to 7,752 new KP.