HIV/SRHR Integration for Key Populations

HIV/SRHR Integration for Key Populations: A review of experiences and lessons learned in India and globally

This report summarises the findings of a review commissioned by India HIV/AIDS Alliance and funded by the European Union of experiences and lessons from integrating HIV and sexual and reproductive health and rights (SRHR) in programmes for key populations which include people living with HIV (PLHIV), sex workers, men who have sex with men (MSM), transgender people and people who use drugs.The report outlines definitions and benefits of HIV/SRHR integration for these key populations and presents some general lessons learned about good practice. It also addresses each of the selected key populations – describing issues to consider within integrated HIV/ SRHR support, sharing key strategies and providing examples of integration in action.

The review was carried out within a context of growing interest in HIV/SRHR integration. There is a growing wealth of evidence that the strategy ‘makes good sense’ and brings concrete benefits – including to people, services and national health systems.

The review specifically responded to the ‘push’ for HIV/SRHR integration within the changing and increasingly complex environment for responses to HIV. Within this context – one characterised by constrained resources, increased demands for cost-efficiency and political re-positioning (with HIV increasingly integrated into wider frameworks for health) – integration is clearly an important strategic option. It also, however, risks being seen as a ‘magic bullet’.

In India – as well as other countries in the Asia and the Pacific Region and globally – there is increasing policy support for the concept of HIV/SRHR integration. However, there remain significant questions and uncertainties about what such programming means in practice. This is particularly the case within the context of a concentrated HIV epidemic – where little is still known about what integration should ‘look like’ (for groups such as sex workers and men who have sex with men) and what practical opportunities and challenges it involves.

However, while integration is a desirable goal in the long-run, concerns remain that the joining of programmes and systems that are not ready could, in fact, compromise the quality of and access to services for key populations. This review identifies a number of challenges and recommendations for SRHR/HIV integrated programmes. These challenges need to be taken into account when national responses aim to scale up SRHR/HIV integrated programming. While this approach clearly has the potential to increase reach and improve quality of interventions, integrating services and systems that are not ready may in the short-run actually compromise outcomes for key populations.

A number of critical questions remain outstanding. These include: Do we have strong evidence to support HIV/SRHR integration as an effective approach to improve both SRHR and HIV outcomes specifically for key populations? If so, what needs to be taken into account to ensure that integration does not compromise access to services for key populations? For example, what type, pace and scale of integration works best for specific populations in specific contexts? And what is possible in the short-term and what goals should be set for long-term?

To download publication click here.

Join Alliance India Sessions on Wednesday, July 25 at AIDS 2012

India HIV/AIDS Alliance has lined up an action packed day for you today (Wednesday 25 July) at the International AIDS conference, you are cordially invited to attend all our sessions to learn more about our work in India to improve the AIDS response for communities most affected by the epidemic. Our commitment is to make sure the voices of these communities are heard at AIDS 2012 and beyond.

Our sessions today range from a panel discussion to oral presentations and poster exhibits, and highlight our experiences in a wide variety of areas, including reaching key populations in SRH/HIV integration; addressing the unmet sexual and reproductive health and rights of people living with HIV; mobilizing female sex workers to increase STI service utilization; findings from our baseline study on people who inject drugs and why we should support the decriminalisation of drug use; and more!

Panel Discussion

Criminalise Hate Not HIV: Why the HIV/AIDS community should support the decriminalisation of drug use.

Organised by INPUD, HRI, IPPF, IFRC and the Alliance, this panel is chaired by Prasada Rao, the UN Secretary-General’s Special Envoy for HIV in Asia and the Pacific and an Alliance Trustee.                                                                                              Wednesday, July 25, Global Village Harm Reduction Zone, 11:00am-12:00 noon

Oral Presentation                                                                                                   

Reaching Key Populations in SRH/HIV integration: Recommendations from a global intervention review to identify strategies to increase the responsiveness and relevance of integrated programming to the sexual and reproductive health and rights (SRHR) needs of high-risk groups, including sex workers, MSM, transgenders, IDUs and PLHIV Session Title: Expanding Covering and Quality: Approaches to Scaling-Up, Mini Room 3,  1:00-2:00pm 

Addressing the unmet sexual and reproductive health and rights (SRHR) of people living with HIV (PLHIV): The results from a baseline study in four states in India.                                                                                                                                Session Title: Expanding Covering and Quality: Approaches to Scaling-Up, Mini Room 3, 1:00-2:00pm 

Poster Exhibition                                                                                                        Wednesday, July 25, Exhibition Hall, Level 2

Beyond Heroin: Patterns of drug choice diversity among People Who Inject Drugs (PWID) in three Indian states: Findings from the Hridaya baseline study.

Identifying quality-of-life priorities for People Who Inject Drugs (PWID): Findings from the Hridaya baseline study in three Indian states.


What’s harming harm reduction? Reducing HIV vulnerability among women who inject drugs in South Asia.    


Reaching people who use drugs (PWUD) in SRH/HIV integration: Recommendations from a global intervention review to identify strategies to increase the responsiveness    

Public private partnership as a sustainable model for STI service delivery: Evidence from Avahan-supported interventions in Andhra Pradesh, India                        

The roadmap contains a full list of posters being exhibited. You can also pick up material about our work at the Alliance exhibition booth #102. If you have any questions, please contact us at

Alliance India Posters on Display at AIDS 2012

Thank you for the overwhelming response and support we got from each of you for the satellite session on Reaching Key Populations through SRH/HIV Integration: Opportunities for Impact at AIDS 2012, we will  be posting deliberations of the discussion that took place during the session soon.

If you’re in DC for the conference, please visit the exhibition hall to view India HIV/AIDS Alliance work (23– 26July 2012), as well as interact with the authors and technical experts from Alliance India. The posters on display today (23 July) are:

Non-Commercial Partner Relationships and HIV Risk among Female Sex Workers in Andhra Pradesh, India

Reaching the hard-to-reach: Community engagement and facilitation as a research strategy with men who have sex with men (MSM), transgender and hijra populations in the Global Fund-supported Pehchan program in India

Are low levels of education among MSM, transgenders and hijras a barrier to building strong community-based organisations (CBOs) to serve as HIV prevention partners? An analysis of data from the baseline survey of the Global Fund-supported Pehchan program in India

Community engagement in the development and roll-out of a capacity building model to strengthen community-based organisations (CBOs) for MSM, transgenders and hijras under the Global Fund-supported Pehchan programme in India

Addressing vulnerabilities of women who inject drugs: A community-based intervention model towards a holistic response to improve health and reduce HIV transmission among women who inject drugs in Manipur, India

Also we look forward to seeing you for today’s satellite session (23rd July 2012) on ‘Future of the HIV Response has Everything to Gain from Realizing Comprehensive SRHR for Everyone’ at Session Room 4 from 6:30-8:30pm, where India HIV/AIDS Alliance partner Daxa Patel, the Board Secretary, Gujarat State Network of PLHIV would be speaking.

We’ll update our blog everyday with details on activities that we are participating in, and will also upload documents so that you can view them online or download them. If you have any questions, please contact us at You can also view our AIDS 2012 Roadmap for all India HIV/AIDS Alliance sessions at the International AIDS Conference. We look forward in connecting with you at AIDS 2012!

Alliance India Events at AIDS 2012 on Sunday, July 22

India HIV/AIDS Alliance invites you today (Sunday, July 22, Global Village Session Room 1, 3:45-5:45pm) for the satellite session on Reaching Key Populations through SRH/HIV Integration: Opportunities for Impact

This session is organised by India HIV/AIDS Alliance with support from European Commission and chaired by UNAIDS, it will present programming experiences highlighting the challenges and successful approaches used in integrated programmes specific to key populations such as MSM and Transgender people, Sex Workers, PLHIV and People Who Use Drugs. Panelists include the Alliance’s Sunita Grote, USAID’s Clancy Broxton, CAMNAFAW’s Nathalie Nkoume, and NEPHAK’s Rahab Mwaniki.

Take a sneak peak on our latest publications that are being showcased today at AIDS 2012 on HIV/SRHR Integration for Key Populations. Please click on the specific title to view or download the publication. Stay tuned for more updates!

New Publication (Policy Brief)
Key Linkages and Key Populations : Is HIV/SRHR Integration Serving the Needs of Vulnerable Communities?

New Publication (Desk Review)
HIV/SRHR Integration for Key Populations : A review of experiences and lessons learned in India and globally

New Publication (Issue Brief)
HIV/SRHR Integration for Sex Workers

New Publication (Issue Brief)
HIV/SRHR Integration for Men who have Sex with Men and Transgender People

New Publication (Issue Brief)
HIV/SRHR Integration for People Living with HIV

New Publication (Issue Brief)
HIV/SRHR Integration for People Who Use Drugs

We’ll update our blog everyday with details on activities that we are participating in, and will also upload documents so that you can view them online or download them. If you have any questions, please contact us at You can also view our AIDS 2012 Roadmap for all India HIV/AIDS Alliance sessions at the International AIDS Conference. We look forward in connecting with you at AIDS 2012!

FROM STIGMA TO STRENGTH – Strategies for MSM, Transgender People and Allies in a Shifting AIDS Landscape

The Global Forum on MSM & HIV (MSMGF) is organizing today (21st July, 2012) the fifth MSM Pre-Conference event to the International AIDS Conference, to be held in Washington, DC. This year’s theme is: From Stigma to Strength: Strategies for MSM, Transgender People and Allies in a Shifting AIDS Landscape. Since its inception in 2006, the MSM Pre-Conference has grown to become the largest global gathering of activists, researchers, implementers and donors focused on the health and human rights of men who have sex with men.

The MSM Pre-Conference will provide a platform for up to 500 participants to exchange the most recent research, best practices, and advocacy strategies that advance the overall goal of universal access. The event will also include networking opportunities and skills building sessions focused on the changing research, programmatic, and policy landscapes in the AIDS sector.

Alliance India is speaking at various sessions and ensuring that the voices of millions are heard. For a more complete overview of sessions visit here.

James Robertson, Country Director, India HIV/AIDS Alliance is moderating a session today morning on Keeping the Pressure Up: A Dialogue with Donors on Increasing HIV Investments Targeted at Programs for MSM and Transgender People

This session on global financing is designed as a dialogue between donors and advocates on donor accountability and the lack of meaningful tracking of resources intended for MSM and transgender HIV programs. The panel will feature experts representing bilateral, multilateral, and private philanthropic agencies. Strategies for what advocates can do at the regional, national, and global levels to directly and meaningfully engage with donors will be discussed.


Simran Shaikh, Programme Officer, Pehchan, India HIV/AIDS Alliance is a speaker for the session on Mounting an Advocacy Response Against Human Rights Violations and Abuses Faced by Transgender Communities Worldwide

This session will feature a panel of trans activists who will discuss various ways in which human rights abuses exacerbate HIV risk and negative health outcomes among transgender communities worldwide. Case study examples highlighting strategies for documenting and challenging these violations at the local, national, regional, and global levels will be discussed. The panelists will shed light on recent successes related to the removing of legal barriers among transgender people in Argentina, Australia, the United States, India, and Sweden.


Jonathan Ripley, former Manager for Advocacy and Policy, Pehchan, India HIV/AIDS Alliance will moderate the session on Speaking Out Loud: Effective Strategies for Managing the Challenges Associated With MSM-Led Advocacy in Central America, North Africa, and Southeast Asia

This session will feature activists from North Africa, Central America, and Southeast Asia sharing their real-life experiences implementing advocacy strategies utilizing a community-led advocacy toolkit for the health and human rights of MSM. Major objectives include sharing the key steps involved with developing and implementing locally specific adaptations of Speaking Out; discussion of the major challenges, successes, and lessons learned from the Speaking Out process; and implications for future regional advocacy activities and initiatives. This session goal is to explore the commonalities, differences, and synergies that occurred while building advocacy capacity for MSM across the 3 regions. Participants will gain an enhanced understanding of the different experiences, knowledge, and approaches used to implement advocacy trainings for HIV and MSM activists in diverse regions. It is expected that this discussion will encourage South-South exchange, maximizing tools and resources to develop and implement local and international advocacy strategies.


Alvaro Bermejo, Executive Director, International HIV/AIDS Alliance will speak on Challenges and Opportunities for Global Fund–Led HIV Programs Among MSM and Transgender People in Low – and Middle-Income Countries

This session is exclusively focused on Global Fund HIV programs among MSM and transgender people. This will give advocates the opportunity to learn more about recent changes within the Fund and the implications of these changes for key populations. Panelists for the session each represent the various core structures of the Fund (Board, Secretariat, Country Coordinating Mechanism, and Grant Recipient) and therefore will bring unique perspectives to the dialogue.

If you have any questions, please contact us at You can also view our AIDS 2012 Roadmap for all India HIV/AIDS Alliance sessions at the International AIDS Conference. We hope to see you at AIDS 2012!

US State Department’s latest Human Rights Report details the status of LGBT rights around the world

“As Secretary, I have worked with my superb team on advancing human rights in a 21st century landscape, focusing on new frontiers even as we stand up against age-old abuses.  Where women have been and continue to be marginalized, we’re helping them become full partners in their governments and economies.  Where LGBT people are mistreated and discriminated against, we’re working to bring them into full participation in their societies.  We’re expanding access to technology and defending internet freedom because people deserve the same rights online as off.  And we know that in the 21st century human rights are not only a question of civil and political liberties, it’s about the fundamental question of whether people everywhere have the chance to make the most of their God-given potential”.

– Secretary Hillary Clinton on the Release of the 2011 Human Rights Report

The US State Department has just released its 2011 Country Reports on Human Rights Practices which documents the status of human rights in countries around the world. The report, as stated by the US Department, serves to inform U.S. government policymaking and serve as a reference for other governments, international institutions, non-governmental organizations, scholars, interested citizens, and journalists. The report also contains a section on Societal Abuses, Discrimination, and Acts of Violence Based on Sexual Orientation and Gender Identity in India.

Assistant Secretary Posner wrote the following in the introduction to the report:
In many countries there was an uptick in discrimination against members of racial and ethnic minorities; people with disabilities; and lesbian, gay, bisexual, or transgender (LGBT) people, all of whom were frequent targets of abuse, discrimination, and violence.  In some countries medical personnel were harassed, intimidated, and arrested.  …

This year’s reports highlight the treatment of marginalized people, including LGBT people and people with disabilities.  Too many countries still criminalize consensual same-sex sexual activity, and LGBT people face discrimination and violence in many more countries.  …

As President Obama has said, societies change from within.  Civil society organizations lead that change by engaging citizens in conversations about how people want to be governed.  These organizations spotlight human rights abuses, fight discrimination, and monitor whether authorities are upholding the rule of law.  They speak out against the exclusion, persecution, or hatred of vulnerable minorities, and document where their societies fall short.  By holding up a mirror to society, they ask their governments and their citizens to do better and to be better.  In all of these ways, civil society groups are the lifeblood of free and open societies, and they are most vital in countries where democratic traditions and institutions are just beginning to take root.

Beyond a Binary: Gender in the work of Alliance India

Shaleen Rakesh’s essay, Beyond a Binary, sheds light on Alliance India’s work with marginalized communities who are the most vulnerable to HIV/AIDS in India. Community members include widows whose husbands have died of AIDS, children living with HIV, women who inject drugs, men who have sex with men (MSM), transgenders and hijras. The connection between these seemingly diverse communities is illuminated in this essay through a focus on the construction of gender, and the role that gender plays in people’s vulnerability to HIV.

Here is an excerpt from the essay:

Gender illuminates, sometimes in the most unexpected ways, the complexity, delicacy and constant contradictions of human interactions. Gender is something that adheres to us, regardless of anatomical sex. The ‘trouble’ arises when we see biological sex as the cause of innate gender traits rather than a construct informed by conditioning, culture, family, age, self-esteem and the space you occupy (to name a few). Gender is not just about women and girls. This essay attempts to configure the surface of the vast landscape of gender which involves men and boys as much as women and girls; connects the dots between gender identities and sexuality; explores its relationship to HIV vulnerabilities; and what interventions can do (and undo) to address an individual’s experience and public expression of gender.

You can read the entire essay here.