Bio-behavioural surveys confirm that HIV prevalence is high or ‘concentrated’ among ‘key populations’ (KPs) who have unprotected sexual contacts with multiple partners or who engage in injecting drug use. These populations include female sex workers (FSW), men who have sex with men (MSM), hijra/transgender (TG), people who inject drugs (PWID), long-distance truck drivers and migrants and HIV disproportionately affects these people. Stigma and discrimination persist everywhere and continue to prevent HIV services from reaching the people who need them most. In addition, young women at childbearing age are also at higher risk of infection and the source of onward transmission to their infants, during birth, labour and through breastfeeding.

Our Approach

Our HIV programmes focus on rapid scaling of prevention, care, and support programmes.

Peer-led intervention Model

Peer education interventions are adopted as a strategy for preventing HIV and other sexually transmitted infections (STIs) among key populations. Peer education programs are based on the rationale that peers have a strong influence on individual behaviour. As members of the target group, peer educators are assumed to have a level of trust and comfort with their peers that allows for more open discussions of sensitive topics. Similarly, peer educators are thought to have good access to hidden populations that may have limited interaction with more traditional health programs.

Risk and Vulnerability Reduction approach

Risk reduction strategies include community-led outreach and behaviour change communications that is differentiated and responsive to community needs; ensuring access to correct knowledge about STI and HIV among female sex workers, men who have sex with men, hijras and their regular partners; negotiation skills for sexual encounters; ensuring access to services for STI and other health problems; promoting male and female condoms; and creating safe spaces.

Vulnerability reduction strategies include developing crisis response systems; advocating with key influencers in the sex work circuit and government including sensitising police about violence against the key population; facilitating access to rights and entitlements through the provision of basic social entitlements and welfare supports such as ration card, children’s education, reducing economic dependence on sex work; and building community ownership through the participation of the key population in the project.

Community Mobilization and Empowering the community through Collectivisation

Community mobilisation is purposefully steered towards the formation of groups or collectives and capacity building of the key population. This enables a larger role for the community-based organisations, prepares them to eventually assume responsibility for the issues that affect them, and empowers them as the natural owners of HIV programs.

Our Achievements

We have won numerous awards including BMGF –AVAHAN Awards, awarded in 2013

> In recognition of Community transition: Successful transfer of CBOs to the government while maintaining quality and community ownership

> In recognition of Institutional building of MARP communities –forming community groups for social cohesion and identity

> In recognition of programmatic innovation to increase accessibility and availability of services and their utilization for MARPs

> In recognition of Resource mobilisation through community events and stakeholder engagement to bring visibility to communities

> In recognition of Advocating and facilitating linkages with government schemes for communities.

Our innovative models have been nationally and globally scaled up, including

> KP intervention models – micro-planning, community mobilisation, peer education

> STI management – colour-coded medicines and private provide engagement

> Rural intervention for HIV prevention (Link Workers Scheme)

> Prevention of Parent to Child Transmission (PPTCT) program

KHPT conducted a research study with the aim of overcome under-testing and under-reporting of paediatric HIV in an A’ Category District in India. The study covered 1000 HIV-positive pregnant women in Belgaum district.

Phase-I of the study was conducted from 2011 to 2014 and Phase-II from 2014 to 2018.

India Learning Network is a knowledge exchange initiative covering selected countries in Asia and Africa.

The initiative influences the global HIV prevention practice by disseminating widely the learning from scaled up HIV prevention interventions in India. It also accelerates the prevention of HIV in participating countries by providing limited in-country technical assistance and follow up support.

The project has influenced implementation plans of international NGOs, government programmes funded by the bi-lateral and multi-lateral agencies, and country-level policies, manuals and guidelines in order to increase coverage of high-risk populations with HIV prevention programs and services.

KHPT implemented the project with support from University of Manitoba, Canada and FHI as the Lead Partner. Bill & Melinda Gates Foundation funded the initiative from 2012 to 2015.

KHPT provided technical support for strengthening community mobilisation and institutional building processes in community based organisations (CBOs). It supported three Female Sex Worker (FSW) CBOs, two Injecting Drug Users (IDU) CBOs in Nagaland and seven IDU CBOs in Manipur.

KHPT partnered with EHA-Project Orchid, Avahan’s State Lead Partner on this project from 2013 to 2014.

National AIDS Control Programme, Phase III (NACP III) designed a Link Worker Scheme (LWS) to provide HIV prevention, referral and follow up services to high risk and vulnerable groups in rural areas.

KHPT was selected as the lead agency to implement this scheme in eight districts in Karnataka – Uttara Kannada, Shimoga, Gadag, Haveri, Chitradurga, Dakshina Kannada, Kolar and Bangalore Rural. The project built strong linkages with District AIDS Prevention and Control Units (DAPCUs) in all the districts and strengthened capacities of several community structures in the target villages.

KHPT implemented the scheme from 2009 to 2012 in partnership with Christian Council for Rural Development and Research (COORR), Samuha, Chaitanya Rural Development Society (CRDS) and Institute of Youth and Development (IYD).

Global Fund to fight against AIDS, Tuberculosis and Malaria (GFATM) funded the project.

Sankalp was the first initiative under which targeted interventions for sex workers, men who have sex with men (MSM) and transgender populations were scaled up in the state of Karnataka.

The project focused on scaling up HIV prevention interventions with key populations in 18 districts of Karnataka reaching over 47,000 FSWs and 15,000 MSM-T in 117 cities or towns, and over 200 village clusters.

The first phase scaled up the interventions and the second phase built capacities of the local communities and the government to assume management of these initiatives.

The project adopted an integrated approach in each priority district, which focused on HIV and STI prevention programmes among female sex workers, behaviour change programme for HIV and STI risk reduction in high risk male populations and improved quality and accessibility of STI management services.

KHPT implemented the project, from 2003 to 2013. KHPT implemented the programme in partnership with NGOs and CBOs in 20 districts of Karnataka and Maharashtra. Bill & Melinda Gates Foundation funded the programme.

Funded by the World Health Organisation (WHO), the pilot intervention looked into developing a curriculum on “Chronic Care” and integrating it into pre-service medical education in Karnataka.

Training content and methods were well received by most faculty and students, who recommended its integration into the regular curriculum.

KHPT implemented the project from July to December 2011 in partnership with Rajiv Gandhi University of Health Sciences, Bangalore and St. John’s Medical College, Karnataka.

Samastha aimed to reduce HIV transmission among vulnerable and high-risk groups in rural areas, build the capacity of health care institutions and facilities to provide high-quality HIV/AIDS care, support and treatment, and promote the use of such services by people living with HIV/AIDS. The project covered rural areas of 12 districts in Karnataka and five districts in coastal Andhra Pradesh.

Partnering with a network of community-based organisations, civil society organisations, academic and training institutions and other related networks, the project resulted in scale up of ART services and creation of experiential learning sites. The project reached 14000 rural female sex workers, 70000 vulnerable men and women, 7000 PLHIV and 5000 orphans and vulnerable children.

The project ushered in innovative models of public private partnership for HIV treatment and care, and catalysed implementation of pre-service pilot training on chronic care based on WHO’s Integrated Management of Adult and Adolescent Illness Model (IMAI).

Samastha, which ran from 2006-2011, was funded by the United States Agency for International Development (USAID). KHPT and University of Manitoba, Canada implemented the programme with technical inputs from Engender Health and Populations Services International.

KHPT also collaborated with the Karnataka State AIDS Prevention Society and the Andhra Pradesh State AIDS Control Society and National AIDS Control Organisation.

In this capacity building project, implemented from 2009 to 2010, KHPT assisted the Karnataka State AIDS Prevention Society in building perspectives among the stakeholders of District AIDS Prevention and Control Units (DAPCUs) .

Sensitization trainings were conducted for public and private stakeholders to facilitate an enabling environment for the functioning of DAPCUs in 26 ‘A’ category districts.

The project was assigned by National AIDS Control Society (NACO) to Avahan, which in turn assigned it to KHPT through the Public Health Foundation of India.

NACP-III recognises counseling as crucial to enabling behaviour change among High Risk Groups (HRGs) in the Targeted Interventions (TI) programmes.

This project aimed at building capacities of the ANM/counsellors to provide counseling services and promote the uptake of Sexually Transmitted Infection services, Antiretroviral Therapy and Integrated Counselling and Testing Centres.

NACO streamlined the counselling training component with technical assistance from KHPT, Public Health Foundation of India (PHFI) and various experts prepared the ANM/Counselling module for counsellors working in TIs. The project was funded by PHFI. KHPT provided technical assistance from 2010 to 2011.

KHPT implemented a community/foster care model to care for children affected or infected by HIV/AIDS in Belgaum and Dharwad districts in Karnataka.

Sixty orphans and 20 women were given psycho-social and education support and livelihood options. Women were trained as foster caregivers. Funded by the Deshpande Foundation, the project was implemented from 2009 to 2010.

Funded by Global Fund for AIDS, Tuberculosis and Malaria (GFATM), Round Six, India, this project aimed at expanding the coverage of and access to services for people living with HIV. It aimed to mainstream HIV/AIDS care into identified private and faith based health facilities.

The project established a system for programme management, regular monitoring, supportive supervision and quality improvement.

It built capacities of the personnel in the identified community care centres with requisite knowledge and skills to deliver quality care to people living with HIV without stigma or discrimination.

KHPT implemented the project, from 2007 to 2010, in partnership with the Catholic Health Association of India (CHAI) in Maharashtra and St. John’s Medical College and Hospital in Karnataka.