Scaling Up HIV Testing Through Community Leadership: Evidence from a One Stop Centre Model for Transgender Populations in India
1
Programme, Plan International (India Chapter), Delhi, India
Popul. Med. 2026;8(Supplement Supplement 1):A1540
ABSTRACT
BACKGROUND:
HIV prevalence among transgender (TG) populations in India remains disproportionately high at 4.78% (HSS 2021). Structural stigma, identity-related marginalization, unstable livelihoods and limited access to sexual and reproductive health (SRH) services impede timely HIV testing and diagnosis. Plan India, is implementing a community-led One Stop Centre (OSC) model to scale up HIV testing through decentralized, integrated and differentiated service delivery for TG populations across 13 states.
METHODS:
The OSC intervention is guided by three
OBJECTIVES:
(i) expanding HIV testing to reach unreached and newly identified TGs; (ii) creating an enabling environment to reduce stigma and discrimination; and (iii) strengthening community empowerment through awareness and social protection linkages. Community-driven OSCs deliver an integrated service package comprising HIV testing, SRH services, STI, TB and viral hepatitis screening, mental health counselling, legal awareness and access to social welfare schemes.
RESULTS:
Out of a total 10,912 previously unreached Transgender were registered, and HIV testing coverage increased steadily over three years: 84.9% (n=5,964) in 2022–23, 91.3% (n=9,223) in 2023–24 and 93.3% (n=10,912) in 2024–25, demonstrating sustained scale-up through decentralized, community-led platforms. 68% were aged 19–29 years and over 83% were below 34 years. Educational attainment was low, with 74% educated up to secondary level or illiterate. Livelihood insecurity was common, with 66% dependent on informal work and 11% unemployed. Moe than one third of HIV testing was delivered through community-based platforms while 23.5% at OSCs. Altogether, 428 TG clients were newly identified as HIV-positive and successfully linked to antiretroviral therapy.
CONCLUSIONS:
Community-led OSCs provide an effective implementation pathway to scale up HIV testing among transgender populations through decentralized, integrated and stigma-reducing service delivery. Sustained improvements in testing coverage, high ART linkage and enrolment of previously unreached TGs highlight the value of community leadership and differentiated service options.
HIV prevalence among transgender (TG) populations in India remains disproportionately high at 4.78% (HSS 2021). Structural stigma, identity-related marginalization, unstable livelihoods and limited access to sexual and reproductive health (SRH) services impede timely HIV testing and diagnosis. Plan India, is implementing a community-led One Stop Centre (OSC) model to scale up HIV testing through decentralized, integrated and differentiated service delivery for TG populations across 13 states.
METHODS:
The OSC intervention is guided by three
OBJECTIVES:
(i) expanding HIV testing to reach unreached and newly identified TGs; (ii) creating an enabling environment to reduce stigma and discrimination; and (iii) strengthening community empowerment through awareness and social protection linkages. Community-driven OSCs deliver an integrated service package comprising HIV testing, SRH services, STI, TB and viral hepatitis screening, mental health counselling, legal awareness and access to social welfare schemes.
RESULTS:
Out of a total 10,912 previously unreached Transgender were registered, and HIV testing coverage increased steadily over three years: 84.9% (n=5,964) in 2022–23, 91.3% (n=9,223) in 2023–24 and 93.3% (n=10,912) in 2024–25, demonstrating sustained scale-up through decentralized, community-led platforms. 68% were aged 19–29 years and over 83% were below 34 years. Educational attainment was low, with 74% educated up to secondary level or illiterate. Livelihood insecurity was common, with 66% dependent on informal work and 11% unemployed. Moe than one third of HIV testing was delivered through community-based platforms while 23.5% at OSCs. Altogether, 428 TG clients were newly identified as HIV-positive and successfully linked to antiretroviral therapy.
CONCLUSIONS:
Community-led OSCs provide an effective implementation pathway to scale up HIV testing among transgender populations through decentralized, integrated and stigma-reducing service delivery. Sustained improvements in testing coverage, high ART linkage and enrolment of previously unreached TGs highlight the value of community leadership and differentiated service options.
| eISSN: | 2654-1459 |
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