Advocating for Cervical Cancer Testing for Women Living With HIV: Experiences from the Koshish Programme in India

Koshish_thumbSexual & reproductive health (SRH) services must respond to the specific needs of people living with HIV (PLHIV). Unfortunately, this is typically still not the case in India. PLHIV face barriers in accessing basic SRH services or have needs that go beyond mainstream services.

After almost two years of rigorous work, Alliance India’s European Union‐supported Koshish programme — named after the Hindi word for ‘effort’— has emerged as a strong initiative to support policies and strategies on SRH for PLHIV in India. Our new case study ‘Advocating for Cervical Cancer Testing in Women Living With HIV’ highlights these efforts to address the challenges that PLHIV face in fulfilling their SRH needs, in this case concerning access to Pap smear testing for women living with HIV (WLHIV).

WLHIV are more vulnerable to cervical cancer and as early detection can lead to improved survival, it is even more imperative to address cervical cancer risk as an advocacy priority, particularly through the promotion of Pap smear testing. In the programme’s four implementation states (Andhra Pradesh, Gujarat, Maharashtra, and Tamil Nadu), Koshish advocacy coalitions have prioritised prevention and early diagnosis of cervical cancer among WLHIV as a key advocacy agenda at state and district levels. The partners have initiated advocacy efforts to make Pap smear testing a mandatory part of the care for every WLHIV and, in doing so, expand its availability to all women.

Read more about this effort here.


India HIV/AIDS Alliance works closely with PLHIV in India through its Koshish programme which strengthens civil society organizations and networks that represent and work with PLHIV and other marginalized groups, such as MSM, transgenders, sex workers and IDUs, to effectively advocate for policies to improve the sexual and reproductive health and rights of PLHIV in India. This project is funded by the European Commission and is implemented in partnership with MAMTA, PWDS, VMM and CHETNA, along with state-level networks for PLHIV in Maharashtra, Tamil Nadu, Andhra Pradesh and Gujarat.

Transforming Identity: New Pehchan Issue Brief on Gender Transition Services in India

Sex Reassignment Surgery (SRS) and cross-sex hormonal therapy are two essential health services required for Male-to-Female (MtF) transgender people to help them align their bodies with their gender identity. Available evidence indicates a near lack of gender identity-related services in even tertiary-level government hospitals, and the offerings in private hospitals are typically unaffordable. This gap persuades many MtF transgender people to seek surgical services from unqualified medical practitioners and face a dangerously high level of complications and inadequate counselling and care.

As part of its advocacy efforts, our Global Fund-supported Pehchan programme documented the current situation for MtF transgender people in India with respect to their access to and use of health services related to gender transition. Based on this study, Pehchan has published a new issue brief, Transforming Identity: Access to Gender Transition Services for Male-to-Female Transgender People in India, which summarizes the research findings, describes barriers, and offers suggestions to improve access to these necessary health services.

Read the complete brief here.


The author of this post, Yadavendra Singh, is Senior Programme Officer: Capacity Building for Alliance India’s Pehchan Programme.

With support from the Global Fund, Pehchan builds the capacity of 200 community-based organisations (CBOs) for men who have sex with men (MSM), transgenders and hijras in 17 states in India to be more effective partners in the government’s HIV prevention programme. By supporting the development of strong CBOs, Pehchan will address some of the capacity gaps that have often prevented CBOs from receiving government funding for much-needed HIV programming. Named Pehchan which in Hindi means ‘identity’, ‘recognition’ or ‘acknowledgement,’ this programme is implemented by India HIV/AIDS Alliance in consortium with Humsafar Trust, PNRO, SAATHII, Sangama, and SIAAP and will reach 453,750 MSM, transgenders and hijras by 2015. It is the Global Fund’s largest single-country grant to date focused on the HIV response for vulnerable sexual minorities.