LINKAGES Quarterly Report (October 1 – December 31, 2017) – India

An accelerated implementation plan was launched in six cluster districts in quarter one of fiscal year 2018, with the strategic guidance of the USAID India Mission and technical support from FHI360. The plan introduced innovative intervention models, including the scale-up of enhanced peer outreach approach, differentiated prevention and care models, and community-led engagement for reach and test. The project generated a case-finding rate of 12 percent through non-TI interventions, with focused testing of new key populations in TIs contributing to more than 70% of new case findings. Community-led engagement with India HIV/AIDS Alliance and one other CBO initiated significant case-finding rates, which need to be taken to scale. Index case testing was initiated in TI and non-TI settings, with spouses and partners showing good case findings that need to be strengthened. The project also pioneered virtual and physical mapping activities, producing tangible benefits in terms of improving the focus of national program efforts on key populations facing the greatest HIV risks. A total of 280 HIV-positive individuals were newly identified this quarter, more than twice the number of newly identified key population living with HIV compared to the Q4 of FY 2017. This is the result of focused efforts to improve case detection by testing most-at-risk key population members, expansion of non-TI approaches, introduction of the index testing strategy, and other activities to improve case detection. Within the targeted interventions, the project extended technical assistance to 75 TIs in six cluster districts, reaching and providing HIV prevention services to 99,048 key populations. All 75 TIs expanded coverage by registering new and unreached key populations in their designated geographical areas. The new hotspots identified through the mapping exercise conducted by LINKAGES last year supported the TIs to expand their coverage. Overall, the TIs registered 2,171 new key populations in Q1 FY18 in five PEPFAR cluster districts. Non-TI approaches were scaled up during the quarter, including EPOA in 5 sites, index case testing in 3 sites, and community-led engagement with HIV/AIDS Alliance and Naari Saksham, an FSW CBO in East Godavari district. A total of 1,275 key populations were reached and provided HIV testing in non-TI settings, with 147 new HIV-positive key populations identified, for a case-detection rate of more than 12 percent of key populations tested. Of the 147 newly identified HIV positives, 131 were initiated on treatment.