PATH is a leader in advancing accessible and high-quality HIV and tuberculosis (TB)/HIV services, community engagement, data use for continuous program and quality improvement (CPQI), and capacity-building. Our Project Sashakt team bring unparalleled subject matter expertise in person-centered, differentiated, and integrated HIV services; trusted relationships with key population (KP) communities, people living with HIV (PLHIV) networks, and the government of India (GOI) at the national, state, and district level; and a robust history of evidence-driven innovations in response to the US Centers for Disease Control and Prevention’s (CDC) “Achieving and Sustaining Epidemic Control in India through Technical Assistance to India’s National AIDS Control Program (NACP) by Strengthening the HIV Prevention to Treatment Cascade under the President’s Emergency Plan for AIDS Relief” project.
Despite the NACP’s progress toward 95-95-95 targets—76% PLHIV diagnosed, 84% on HIV treatment, and 80% with undetectable viral loads (VL)—there remains an estimated 560,000 PLHIV who need to be diagnosed, linked, and supported on treatment through durable viral suppression. The need for more meaningful engagement of communities in designing and monitoring service provision as well as systematized use of CPQI processes at the state and district levels to plan and execute HIV programming to reach epidemic control goals is clear.
Purpose: Implement comprehensive activities and services across the prevention and treatment cascade, specifically by addressing the high burden of HIV and TB/HIV among high-risk groups, including KP, through people-centered service delivery; and building on existing efforts while embracing innovation in prevention, case-finding, treatment continuity, and durable VL suppression through catalytic activities.
Approach: PATH and our consortium team members—Science Health Allied Research Education, the Network of Maharashtra by People Living with HIV/AIDS, the Humsafar Trust, and I-TECH India—will partner with the CDC and the GOI to accomplish this purpose by applying principles of equity, transparency, and accountability. Three foundation pillars will drive forward sustained, evidence-based, client-centered, and high-quality HIV and primary health care programming for unreached KPs, at-risk migrants, adolescents, and their partners: 1) Institutionalized capacity-strengthening through use of community-led monitoring and CPQI processes to implement integrated, cost-effective, client-responsive, and quality-assured HIV programming; 2) Iterative innovation by leveraging private-sector partnerships, applying Plan-Do-Check-Act principles, and involving community stakeholders to iteratively refine innovations for scale and NACP adoption; and 3) Integrated, community-engaged programming through coaching site-level providers and strengthening referral networks to facilitate access to multiple health services (TB, viral hepatitis, harm reduction, noncommunicable diseases, mental health) at client touchpoints.
Outcomes: Our work will include 16 targeted activities contributing to three strategies: 1) Develop and implement evidence-based, people-centered, HIV and HIV/TB prevention, case-finding, and linkage programs; 2) Strengthen integrated, community-engaged programming to increase HIV treatment coverage (including TB/HIV) treatment continuity, and VL suppression among all PLHIV/children living with HIV; and 3) Build capacity of district and state teams to routinely utilize and disseminate timely data for continuous programmatic improvement and identify gaps, emerging clusters, and improve prevention and treatment continuum in collaboration with national and state teams. These activities will drive progress toward 17 short-term, intermediate, and long-term outcomes, which aim to support the NACP in achieving epidemic control in priority geographies (Mizoram, Manipur, Nagaland, and Mumbai in Year 1).
