Success Stories
COVID-19 lockdown hit the HIV/AIDS patients hard since it meant that they could not receive the periodic medical care and treatment which is necessary to keep them healthy and well. The sudden discontinuation of transportation services to curb the COVID -19 pandemic left most of these PLHIV anxious about their monthly drug refill status since these drugs were not available at district level.

Responding to the COVID-19 situation, I-TECH India supported the State AIDS Control Societies in the states of Maharashtra, Manipur, Nagaland and Mizoram, to plan the ART drug delivery to rural and other inaccessible areas. In Maharashtra, I-TECH India telephonically reached out to the PLHIVs across the state through an IVRS menu specially designed for this situation. Below are some success stories of I-TECH India’s response during COVID-19.

Bringing HIV services closer to Home

• Neha (name changed), a PLHIV from Satara district in Maharashtra was anxious about the lockdown situation caused due to COVID -19 pandemic; travelling to J. J. Hospital, Mumbai (250 kms) for pill collection was not permitted. Being on 3rd line ART treatment she was aware about the dreadful consequences of non – adherence. I-TECH India reached out to her telephonically with information on provision of ART at her nearest ART Centre. With restricted movement and no transportation, travelling 30 kms to the nearest ART, Centre, in addition to the fear of exposure to COVID – 19 infection, was yet another challenge. With a bicycle from the neighbourhood to convincing police personnel with the help of the Program Officer at I-TECH India, she could reach the ART Centre and receive her muchneeded ART pills.

  “Thank you for calling me and informing about the availability of medicine at the nearby ARTC, as I had no idea whom to contact and how to collect medicine and was not expecting to get a call from J.J ART” said Neha.

• Anand (name changed) was at his native place in Jalna district when the sudden lockdown was announced. He was unable to reach his parent ART Centre in Pune to collect his monthly drug refill. It was then that he remembered about the call from ART Centre. The Programme Assistant had called him a few months back as he had missed his visit to the ART Centre on the due date; he had saved the incoming call number to his mobile. Now, he contacted the Programme Assistant requesting help for making ART available from a nearby ART Centre. The Programme Assistant (I-TECH India) not only linked him to the nearby ART Centre but also coordinated with the parent ART Centre in Pune to get details pertaining to treatment regimen and registration number failing which he would be
  denied drug refill at the nearby ART Centre.

  Anand happily states “When we receive such call from ARTC to follow up on our treatment status we feel there is somebody who cares for us and it was with this trust that I called as I knew I would be helped to get my medicine”

• Anil (name changed) works in an orphanage in the district of Osmanabad. He is on 3rd line treatment at J. J. Hospital, Mumbai. When Anil was contacted by I-TECH India, he informed that he would also need monthly refill for the 5 positive children at the orphanage where he works as Senior In-charge. I-TECH India co-ordinated with J J Hospital as well as the district Hospital in Osmanabad to facilitate availability of 3rd line drugs for Anil as well as monthly refill for all the 5 children at the orphanage.

  Anil states “I travelled multiple times to the district hospital 30 kms away to check if ART drugs were available. Thanks to the coordination of I-TECH India official. I received my 3rd line pills at district hospital and could get monthly refill for the 5 positive children at the orphanage where I work as Senior In-charge”.

Door- step consultations

• Shanta (name changed), a PLHIV from Satara district seeking alternative 2nd line treatment from JJ Hospital in Mumbai, was glad to hear from I-TECH India that the medicines could be made available at the nearest ART centre during the lockdown period. Her treatment regimen was revised a few days back. She had a medical history of allergic drug reactions to many drugs. On day 4 of her revised treatment, she developed skin rash all over the body. Unable to physically reach the parent ART Centre, she stopped taking one of the pills thinking that the drug caused the rash. However, the rash remained. Her son called back on the number from where he had received information on availability of ART during the lockdown situation. Fortunately, it was the contact number of Medical Advisor at I-TECH India who after taking detailed medical history & progress of the rash advised to stop the pill that was inducing rash and continue the other pills. He also advised her not to experiment with pill dosage without proper medical consultation.

Coordination between States

• Maharashtra has a high number of migrants coming from various states who are enrolled in the ART Centres across Maharashtra for receiving ART treatment. The situation of these migrants became difficult since they had to return to their states and did not have access to treatment in their native location.

  I-TECH India worked with Maharashtra State AIDS Control Society (MSACS) to support such patients. MSACS shared the list of clients who had missed their appointment at the ARTC due to lockdown during COVID-19; Sushma (name changed) was one of them.

  Sushma, a PLHIV registered at Thane Civil ART Centre (Maharashtra State), was in Bhuj District of Gujarat during the lockdown period. She was informed by I-TECH India about the provision to collect her ART pills from the nearest ART Centre in Bhuj. However she was initially denied pills as she could not prove her on-going treatment status (documentation, registration no. etc). She contacted the I-TECH India again.

  Since the Thane ARTC, her parent ARTC, was shut down due to detection of a Corona positive case and the ARTC was shifted to a nearby ARTC in Kalwa, the efforts from ITECH India to get the details of this client from Thane & Kalwa ARTC as well as the Maharashtra SACS were not successful. From the information available in the missed appointment client list received from MSACS, I-TECH India officials gave the details to Sushma who in turn could submit the details to the Bhuj ART Centre. The Senior Programme Officer at I-TECH India contacted the concerned officials at the Bhuj ARTC. Sushma was given ART pills for 2 months. Later, her husband too contacted I-TECH India & informed that he was issued medicines for 3 months from Thane ARTC and his pills would last until the 30th of the current month. Senior officials at I-TECH India coordinated with MSACS and Bhuj ART Centre for details regarding Sushma’s husband & it was agreed by Bhuj ART Centre to issue ART pills to Sushma’s husband on 30th of current month.

  Sushma sounded relieved when she said “Both me & my husband were tensed about not receiving the monthly ART refill. Thanks to I-TECH India who helped us in every possible way to get us the much-needed pills.”

Keeping Pregnant women safe

• Manisha (name changed), a positive ANC from Baramati in Pune district of Maharashtra was stuck in Raigad district during the lockdown. She was on 3rd line treatment at JJ Hospital, Mumbai.

  Programme Officer, I-TECH India contacted Manisha to get details on her current location & willingness to collect ART refill at the nearest ART Centre. Her husband informed that Manisha was in her second trimester and requested for home delivery of ARV. However, changed his mind due to the fear of disclosure of HIV status and collected ART refill from Pune ARTC.

  A month later he contacted I-TECH India requesting to arrange for monthly refill as travelling was strictly restricted due to lockdown. The couple was worried that nonadherence to treatment due to stock out of monthly refill would have ill effects on the HIV status of their baby.

  I-TECH India was closely monitoring the supply chain management of ART drugs and ensuring uninterrupted ART supply to the PLHIV in Maharashtra. I-TECH team coordinated with various district officials and facilitated provision of 3rd line medicines to the positive ANC through the closest ARTC.

  During the next monthly ART due refill date, Manisha’s husband was asked to contact the Counsellor at Reliance ARTC and / or I-TECH India for confirming availability of ART pills at nearest ARTC to ensure treatment adherence and viral suppression.

  The couple expressed gratitude for the support extended by I-TECH India and the Raigad ARTC in time of distress.

  ART refilling through Differentiated Services Delivery Model I-TECH India supported the implementation of the Differentiated Service Delivery Model (DSDM) through Targeted Intervention (TI) NGOs serving the key populations
  (FSW, MSM/TG) in Pune district.

  The sudden discontinuation of transportation services under nationwide lockdown due to COVID-19 disrupted the ART services to a large extent. The red-light area in Pune was sealed making it difficult for the KPLHIV access ART centers in district to collect their monthly refill. The TI NGO staff were guiding the KPLHIV to collect medicine at any nearby ARTC as well as facilitating home delivery of medicines by ORW and Peer Educators.

  I-TECH India in consultation with the District AIDS Prevention & Control Unit (DAPCU), Pune connected virtually with the DSDM –TI Program Managers to plan ART delivery for KPLHIV at the DSD site. Willing KPLHIV can collect ART refill from DSD site, irrespective of his/her linkage to DSD site.

  I-TECH India coordinated for the approval of ART refill through DSD-TI ART refilling centre and arranged for the delivery of ART to the sites. The TI staff visited the nearest health facility (Gadikhana Hospital) to collect the ART refill for KPLHIV. The prompt action of DSD-TI staff and support from DPO helped in providing monthly ART refill to the KPLHIV from DSD-TI ART refilling centers.

Decentralized models for viral load testing

• Due to the outbreak of COVID-19, many hospitals in Northeast were converted to COVID19 care centres and some ART centres were temporarily closed or shifted out of the hospital premises. Laboratories were not functioning properly due to inadequate staff and more focus on conducting COVID testing. These factors hampered the accessibility to hospitals and basic HIV services for PLHIV, including viral load testing. To address this issue, I-TECH India started organising viral load sample collection camps in community settings, targeted intervention sites and peripheral health facilities in the state of Manipur. Taking the learnings from the model piloted in Manipur into consideration, the National AIDS Control Organisation (NACO),GoI approved scaling up of the model to the rest of the state and the region. At present, viral load sample collection camps are conducted on a regular basis in Mizoram, Manipur and Nagaland to improve coverage and make the services more accessible to PLHIV from difficult-to-reach and distant terrains.