Abstract

Introduction: Despite expansion of antiretroviral therapy that has transformed HIV into a manageable chronic condition, service disruptions and fragmented care persist. In line with the World AIDS Day 2025 theme, “Overcoming disruption, transforming the AIDS response,” this paper explores ground-level experiences of HIV service delivery and identifies opportunities for strengthening a resilient, people-centred response. Methodology: A need assessment analysis, using qualitative exploratory approach, was conducted for the purpose of planning delivery of outreach services for HIV through a Medical College in Delhi. The overall methodological approach aligned with the World AIDS Day 2025 theme, “Overcoming disruption, transforming the AIDS response”. The field component was carried out in seven Targeted Intervention (TI) projects operated by non-governmental organizations (NGOs). Information was gathered through informal, loosely structured, group interactions with staff and service beneficiaries at each NGO. Observations: Persistent fragmentation of HIV care and disruption of services was observed. Stockout of supply often resulted in disruption of services. NGOs played a critical but informal role in care coordination and psychosocial support. Comparative analysis highlighted that integrated service delivery, community-led interventions, and institutionalized stigma-reduction strategies were associated with improved engagement and resilience in HIV programmes. Conclusion: Transforming the AIDS response in India requires moving beyond a vertical, disease-centric model toward integrated, inclusive, and community-centred health systems. Strengthening service integration and institutionalizing community participation are essential to overcoming disruptions and achieving the goal of ending AIDS as a public health threat by 2030.

• 1.   World Health Organization. HIV and AIDS [Internet]. Geneva: World Health Organization; 2025 Jul 15 [cited 2025 Dec 15]. Available from: https://www.who.int/news-room/factsheets/detail/hiv-aids.
• 2.   World Health Organization. World AIDS Day 2025: Overcoming disruption, transforming the AIDS response [Internet]. Geneva: World Health Organization; 2025 [cited 2025 Dec 15]. Available from: https://www.who.int/ campaigns/world-aids-day/2025.
• 3.   National AIDS Control Organisation (NACO). India HIV Estimates 2023: Technical Report [Internet]. New Delhi: Ministry of Health and Family Welfare, Government of India; 2024 Dec 17 [cited 2025 Dec 15]. Available from: https://naco.gov.in/sites/default/ files/India%20HIV%20Estimates%202023_ Technical%20Report_Final_17%20DEC%20 2024%20%281%29.pdf
• 4.   Pollard R, Gopinath U, Reddy YA, Kumar BR, Mugundu P, Canjeevaram K, et al. HIV service delivery in the time of COVID-19: focus group discussions with key populations in India. Journal of the International AIDS Society 2021, 24(S6):e25800http://onlinelibrary.wiley.com/ doi/10.1002/jia2.25800/full. DOI:https://doi. org/10.1002/jia2.25800.
• 5.   PIB. World AIDS Day. Building on India’s global AIDS control success. [Internet]. Press Information Bureau, Government of India; 2025 Nov 30. [cited 2025 Dec 15]. Available from: https://www.pib.gov.in/PressReleseDetailm. aspx?PRID=2196475®=3&lang=1.
• 6.   UNFPA Zimbabwe. Sista2Sista Mentors Manual. [Internet]. [cited 2025 May 6]. Available from: https://zimbabwe.unfpa.org/ en/publications/sista2sista-mentors-manual.
• 7.   Janamnuaysook R, Taesombat R, Wong J, Vannakit R, Mills S, van der Loeff MS, et al. Innovating healthcare: Tangerine Clinic’s role in implementing inclusive and equitable HIV care for transgender people in Thailand. J Int AIDS Soc. 2025 ;28(1):e26405.
• 8.   Ayala G, Sprague L, van der Merwe LLA, Thomas RM, Chang J, et al. (2021) Peer- and community-led responses to HIV: A scoping review. PLOS ONE 16(12): e0260555. https:// doi.org/10.1371/journal.pone.0260555.

Data Sharing Statement

Funding