{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T05:40:16Z","timestamp":1781761216742,"version":"3.54.5"},"reference-count":34,"publisher":"Wiley","issue":"S6","license":[{"start":{"date-parts":[[2021,10,28]],"date-time":"2021-10-28T00:00:00Z","timestamp":1635379200000},"content-version":"vor","delay-in-days":27,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000200","name":"United States Agency for International Development","doi-asserted-by":"publisher","award":["#72038619CA00001"],"award-info":[{"award-number":["#72038619CA00001"]}],"id":[{"id":"10.13039\/100000200","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Int AIDS Soc."],"published-print":{"date-parts":[[2021,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>There are limited data on the impact of COVID\u201019\u2010associated disruptions and novel HIV service delivery strategies among key populations (KPs) in low\u2010 and middle\u2010income countries. In March 2020, in response to COVID\u201019, the Government of India revised HIV service delivery policies to include community antiretroviral therapy (ART) distribution and multi\u2010month dispensing (MMD) of ART for all people living with HIV (PLHIV).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>To assess the acceptability of these adaptations and impact of the pandemic among KPs, we conducted focus groups in November\u2013December 2020 with purposively sampled men who have sex with men (MSM), female sex workers (FSWs) and transgender women (TGW) in Telangana and Maharashtra. Seven discussions were conducted. Topics included HIV service access, risk behaviours, economic security and feedback to ensure service continuity. Inductive coding identified themes across topics.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Forty\u2010four individuals aged 20\u201349 years participated in discussions (13 MSM; 16 FSW; and 15 TGW). Twenty\u2010four participants self\u2010identified as living with HIV. People not living with HIV reported challenges in accessing HIV antibody testing at hospitals due to travel restrictions and fear of contracting COVID\u201019. Participants accessed HIV antibody testing using transportation arranged by community\u2010based organizations after lockdowns eased. PLHIV reported uninterrupted ART refills and generally consistent adherence; however, there were experiences of delayed CD4 and HIV RNA testing. Participants shared appreciation for MMD as it saved time, money, and reduced exposure to COVID\u201019. Participants expressed gratitude for home deliveries which enabled ART access, yet shared concerns about home\u2010based services causing confidentiality breaches with family\/neighbours. Participants voiced preferences for community\u2010based service provision due to proximity, convenient hours, and welcoming environments compared to public hospitals. Other requests included support for income, employment, nutrient\u2010rich food and more accessible mental health, HIV, and other health services.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>COVID\u201019 restrictions had a greater impact on access to HIV antibody, CD4, and RNA testing services compared to ART access. High acceptance of MMD and community\u2010based services support the continued role of differentiated service delivery models to improve KP access to HIV antibody, CD4, RNA testing services, convenient ART retrieval, and integrated services beyond HIV, which may be critical for survival and wellbeing.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jia2.25800","type":"journal-article","created":{"date-parts":[[2021,10,29]],"date-time":"2021-10-29T05:37:44Z","timestamp":1635485864000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":27,"title":["HIV service delivery in the time of COVID\u201019: focus group discussions with key populations in India"],"prefix":"10.1002","volume":"24","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9563-0918","authenticated-orcid":false,"given":"Rose","family":"Pollard","sequence":"first","affiliation":[{"name":"Division of Infectious Diseases The Johns Hopkins University School of Medicine  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Usha","family":"Gopinath","sequence":"additional","affiliation":[{"name":"YR Gaitonde Center for AIDS Research and Education  Chennai India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yeruva A.","family":"Reddy","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases The Johns Hopkins University School of Medicine  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bogam R.","family":"Kumar","sequence":"additional","affiliation":[{"name":"YR Gaitonde Center for AIDS Research and Education  Chennai India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Parthasarathy","family":"Mugundu","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases The Johns Hopkins University School of Medicine  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Canjeevaram K.","family":"Vasudevan","sequence":"additional","affiliation":[{"name":"YR Gaitonde Center for AIDS Research and Education  Chennai India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aylur K.","family":"Srikrishnan","sequence":"additional","affiliation":[{"name":"YR Gaitonde Center for AIDS Research and Education  Chennai India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aditya","family":"Singh","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases The Johns Hopkins University School of Medicine  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Allison M.","family":"McFall","sequence":"additional","affiliation":[{"name":"Department of Epidemiology The Johns Hopkins Bloomberg School of Public Health  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7460-733X","authenticated-orcid":false,"given":"Kenneth H.","family":"Mayer","sequence":"additional","affiliation":[{"name":"Department of Medicine Beth Israel Deaconess Medical Center\/Harvard Medical School  Boston Massachusetts USA"},{"name":"Fenway Health The Fenway Institute  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shruti H.","family":"Mehta","sequence":"additional","affiliation":[{"name":"Department of Epidemiology The Johns Hopkins Bloomberg School of Public Health  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sunil S.","family":"Solomon","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases The Johns Hopkins University School of Medicine  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,10,28]]},"reference":[{"key":"e_1_2_9_2_1","unstructured":"National AIDS Control Organisation and ICMR\u2010National Institute of Medical Statistics. India HIV Estimates 2019 Report. 2020 [accessed March 1 2021]. Available from:http:\/\/naco.gov.in\/sites\/default\/files\/INDIA%20HIV%20ESTIMATES.pdf."},{"key":"e_1_2_9_3_1","unstructured":"World Health Organization.Consolidated guidelines on HIV prevention diagnosis treatment and care for key populations.Geneva:WHO;2016."},{"key":"e_1_2_9_4_1","volume-title":"Sankalak: Status of National AIDS Response (Second edition, 2020)","author":"National AIDS Control Organisation","year":"2020"},{"key":"e_1_2_9_5_1","volume-title":"National Technical Guidelines on Anti Retroviral Treatment","author":"National AIDS Control Organization","year":"2018"},{"key":"e_1_2_9_6_1","unstructured":"Center for Systems Science and Engineering (CSSE) at Johns Hopkins University (JHU). COVID\u201019 dashboard [accessed July 1 2021]. 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