Coronavirus pandemic has created an almost unimaginable crisis in India and our public health system were unprepared for the speed and severity of the virus. The impact of the virus was much severe among key populations like transgender people, sex workers, men who have sex with men and people living with HIV. These populations live below the poverty line with low levels of literacy and education. Social prejudice and stigma further worsened the situation limiting them in seeking the health services like vaccination and testing. Many of them live in slums, washing hands, wearing masks and social distancing is either not understood or challenging to practice as they live in small houses and use community toilets.

“Parivartan’ (meaning change/innovation) project is supported by Frontline AIDS through EJAF funding and is being implemented in Surat city of Gujarat. The project has identified four locations namely Varachha, Udhna, Katargam and Sarthana Jakatnaka for intervention

Innovative programme strategies

Learning from existing projects and best practices, the programme adopted the following innovation strategies to address the Covid impact among the key populations.

• Participatory social mapping was done to identify the location of the project population, their risk perception or assessment for COVID-19 exposure, challenges in practising COVID-19 prevention protocols.
• Virtual outreach services to key populations to empower them with complete and correct information on COVID-19 prevention and care. Digital platform and IEC materials were provided on COVID-19 awareness, prevention, associated stigma and discrimination reduction for health care providers, community leaders, and outreach workers.
• Key population communities were also provided with sanitisers, masks, nutrition support and medications as needed.
• Advocacy and sensitization with health care service providers to create an enabling environment that will encourage key population groups in accessing COVID-19 related services like testing, vaccination.
• Vaccination camps: Traditionally vaccination was provided at public health facilities and many key population groups like FSW, MSM/TG due to fear of being stigmatized or discriminated and long waiting periods used to avoid visiting these facilities for vaccination. Also, PLHIV hesitates to visit public health facilities due to fear of exposure to COVID-19. The project has partnered with the Surat Municipal Corporation to provide vaccination free of cost from the government supply. These camps were organized in a stigma-free environment following all vaccination protocols.

Some qualitative results

• 2194 (Male – 1355; Female – 839) PLHIVs were reached virtually with COVID-19 information and screening and 15 suspected cases among them were referred to the health facility for COVID-19 testing.
• Two vaccination camps were organized in stigma-free and easily accessible sites and 180 key populations were provided vaccination free of cost by government medical teams.

Next Steps

As this is an innovation grant, the project will focus on documenting the lessons and best practices and explore strategies to scale up the programme to other geographical areas.