Scaling Decentralized, Integrated HIV Services for Mobile Populations: Evidence from India’s One Stop Centre Model
1
Programme, Plan International (India Chapter), Delhi, India
Popul. Med. 2026;8(Supplement Supplement 1):A1533
ABSTRACT
BACKGROUND:
Although overall adult HIV prevalence in India remains low, it is nearly five times higher among long-distance truckers (1.00%; 95% CI: 0.78–1.21). Truckers and migrant workers function as critical bridge populations due to high mobility, occupational risk, and limited continuity of healthcare access. To support India’s National AIDS Control Programme (NACP) goals, Plan India implemented a One Stop Centre (OSC) intervention across 15 states to expand integrated, community-led service delivery for these mobile populations.
METHODS:
The OSC intervention was guided by three strategic
OBJECTIVES:
(i) expanding service coverage beyond HIV to include TB, STI, viral hepatitis, and NCDs; (ii) creating enabling environments to reduce stigma and discrimination; and (iii) strengthening community empowerment through awareness, skills development, and social protection linkages.
RESULTS:
Between 2022–23 and 2024–25, HIV testing coverage increased steadily from 76.3% to 86.0%, reflecting strengthened integration of HIV services within decentralised outreach models. Overall, 190,327 truckers and migrants were registered during the study period, with 76.6% first reached through hotspots and 16.7% outreach sites, underscoring the importance of non-facility platforms. Integrated service delivery achieved substantial scale, including TB screening for 188,164 clients, STI screening for 134,814, viral hepatitis screening for over 35,000, and NCD screening for blood pressure (139,539) and blood sugar (73,284). While decentralised outreach achieved wider population coverage with lower HIV positivity yield, facility-based services identified higher-risk clients (OR = 2.38; 95% CI: 1.89–2.99; p < 0.001).
CONCLUSIONS:
The OSC model demonstrates that decentralised, integrated service delivery can be rapidly scaled among highly mobile trucker and migrant populations. The complementary strengths of outreach-led coverage and facility-based diagnosis support hybrid delivery models as an effective pathway to improve early detection, continuity of care, and equity; directly advancing NACP objectives through mobility-responsive HIV programming.
Although overall adult HIV prevalence in India remains low, it is nearly five times higher among long-distance truckers (1.00%; 95% CI: 0.78–1.21). Truckers and migrant workers function as critical bridge populations due to high mobility, occupational risk, and limited continuity of healthcare access. To support India’s National AIDS Control Programme (NACP) goals, Plan India implemented a One Stop Centre (OSC) intervention across 15 states to expand integrated, community-led service delivery for these mobile populations.
METHODS:
The OSC intervention was guided by three strategic
OBJECTIVES:
(i) expanding service coverage beyond HIV to include TB, STI, viral hepatitis, and NCDs; (ii) creating enabling environments to reduce stigma and discrimination; and (iii) strengthening community empowerment through awareness, skills development, and social protection linkages.
RESULTS:
Between 2022–23 and 2024–25, HIV testing coverage increased steadily from 76.3% to 86.0%, reflecting strengthened integration of HIV services within decentralised outreach models. Overall, 190,327 truckers and migrants were registered during the study period, with 76.6% first reached through hotspots and 16.7% outreach sites, underscoring the importance of non-facility platforms. Integrated service delivery achieved substantial scale, including TB screening for 188,164 clients, STI screening for 134,814, viral hepatitis screening for over 35,000, and NCD screening for blood pressure (139,539) and blood sugar (73,284). While decentralised outreach achieved wider population coverage with lower HIV positivity yield, facility-based services identified higher-risk clients (OR = 2.38; 95% CI: 1.89–2.99; p < 0.001).
CONCLUSIONS:
The OSC model demonstrates that decentralised, integrated service delivery can be rapidly scaled among highly mobile trucker and migrant populations. The complementary strengths of outreach-led coverage and facility-based diagnosis support hybrid delivery models as an effective pathway to improve early detection, continuity of care, and equity; directly advancing NACP objectives through mobility-responsive HIV programming.
| eISSN: | 2654-1459 |
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