BACKGROUND:
While India has made significant progress in reversing the HIV epidemic, HIV testing coverage among pregnant women remained critically low in several states in 2015. Complementing the Government of India’s National AIDS Control Programme (NACP) and EMTCT strategy, Plan India implemented the Global Fund–supported AHANA Project in 13 states. Description: Three-pronged strategy was adopted (a) capacity building of over 40,000 community health workers across government health facilities to institutionalize routine HIV testing during ANC; (b) sustained national and sub-national advocacy to ensure procurement and uninterrupted supply of HIV test kits and consumables; and (c) demand generation among pregnant women to promote early and repeated HIV testing during pregnancy. Lessons Learned /

RESULTS:
HIV testing coverage among pregnant women increased from 34% (n=14 million) in 2016–17 to 92% (n=13.8 million) in 2023–24. This expansion resulted in a 25% increase in identification of HIV-positive pregnant women between 2016–17 and 2023–24. Over 30,000 HIV-positive pregnant women were identified, linked to ART services, and followed up for care and support during 2016–24. Early ART initiation during the ANC phase improved from 79% to 88%. Institutional delivery among HIV-positive pregnant women increased from 90% to 93%. More than 16,000 infants were confirmed HIV-negative after receiving definitive testing at 18 months contributing directly reducing the transmission by more than half from 25.28% in 2019 to 11.75% 2023.

CONCLUSIONS:
Capacity enhancement of peripheral public health units, combined with community-driven HIV screening and strong supply-side advocacy, resulted in a manifold increase in HIV testing among pregnant women. Testing services were decentralized from district hospitals to all Primary Health Centres (PHCs) and further to Village Health and Nutrition Days (VHNDs), effectively taking HIV testing to the doorstep of pregnant women.