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Strengthening integrated service delivery models

For the at-risk & incarcerated targeted populations in India to work towards achieving the fast-track 95-95-95 targets

Strengthening Integrated Service Delivery Models for the At-Risk & Incarcerated Targeted Populations in India


The project seeks to work with the key PLHIV populations, who cannot access the traditional Target Intervention (TI) model. Given the COVID pandemic, mitigation effort and reverse migration, the project is critical in ensuring prevention of HIV/ STI among these risk groups. The activities under this grant will supplement the national programs efforts through an Integrated care approach, by networking and linkages with existing TIs and departments.


Persons Incarcerated
Persons Incarcerated
People Who Inject Drugs
People Who Inject Drugs
Migrants and Truckers
Migrants and Truckers
Goal profile
Kaveesher Krishnan
Project Lead


Having substantial experience with setting up and offering successful integrated care services across India, YRGCARE is working towards establishing strong interventions that reach key objectives with rigorous scientific processes and provide documented good practices for replication for other incarcerated settings as well, tweaking these approaches to suit the uniqueness of each targeted group setting.


The programme seeks to achieve the following objectives by March 2024 -

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Expand HIV and other critical health interventions for incarcerated populations in prisons & other closed settings in 5 East and 8 North East states of India

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Develop integrated service delivery models through one-stop centres for clinical and behavioural aspects of HIV and social protection services among transgenders (TG), People who use/inject drugs (PWUD/ PWID) and Bridge population (BP) across India

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Strengthen the capacities of the TG, PWUD/PWID communities, CBOs, networks and strengthening systems leading to increased community participation in the national response through systematic approach that supplements the ongoing TI programme across India.


Map 1 6 3 4 5 2 7 1 3 4 5 2 5 8 3 6 2 4 7 1 7 8 4 5 3 2 1 6 5 4 3 1 2
Region 1
  • 1 Madhya Pradesh
  • 2 Maharashtra
  • 3 Gujarat
  • 4 Rajasthan
  • 5 Uttar Pradesh
Region 2
  • 1 Chandigarh
  • 2 Haryana
  • 3 Himachal Pradesh
  • 4 Jammu & Kashmir
  • 5 Ladakh
  • 6 New Delhi
  • 7 Punjab
  • 8 Uttarakhand
Region 3
  • 1 Arunachal Pradesh
  • 2 Assam
  • 3 Manipur
  • 4 Meghalaya
  • 5 Mizoram
  • 6 Nagaland
  • 7 Sikkim
  • 8 Tripura
Region 4
  • 1 Bihar
  • 2 Chhattisgarh
  • 3 Jharkhand
  • 4 Odisha
  • 5 West Bengal
Region 5
  • 1 Andhra Pradesh
  • 2 Goa
  • 3 Karnataka
  • 4 Kerala
  • 5 Pondicherry
  • 6 Tamil Nadu
  • 7 Telangana


HIV Care Cascade

The HIV care cascade encompasses a complete range of services for HIV prevention and treatment, specifically for key and bridge populations within the programme. This sequence typically involves diagnosing HIV, ensuring the initial linkage to care, initiation and adherence to antiretroviral therapy (ART), and keeping individuals engaged in care over time. In this project, all three components offer these services both directly and indirectly to key populations.

HIV Care Cascade
Integrated Health Screeening

This involves thorough screening, diagnosis, treatment initiation, and follow-up for five major diseases: STIs (Sexually Transmitted Infections), Syphilis, Tuberculosis, HIV, and Viral Hepatitis.

In the OSC component, these services are offered to three specific groups: bridge populations, People Who Inject Drugs (PWID), and transgender individuals. Conversely, the Prison and OCS component primarily focuses on delivering these services to the incarcerated population.

Importantly, these services are provided through collaborations with the Integrated Counselling & Testing Centre (ICTC), Anti-retroviral Therapy (ART) Centre, and other relevant stakeholders.

Integrated Health Screeening
Linkages to social entitlements and benefit schemes

To address the vulnerabilities that may lead to HIV risk behavior, the programme utilises various public benefit schemes and helps individuals access entitlements that promote social inclusion and alleviate economic hardships.

Linkages to social entitlements and benefit schemes
Prison-based specific services

The Prison and OCS component mainly provides 10 essential service components, which include SBCC/ IEC, Prevention of medical transmission, PPTCT, Vaccination & Prevention of Viral Hepatitis, Integrated Testing & Counselling for HIV, Prevention of Sexually Transmitted Diseases, Prevention of Tuberculosis, Opioid Substitution Therapy for Persons Who Inject Drugs, Anti-retroviral Therapy.

Prison-based specific services
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