| Individual-level barriers |
1. Drug detoxification and rehabilitation services should be provided to the PWIDs as a part of the programme. |
1. OST should be started for PWIDs before initiating ART |
| 2. Biometric System should be introduced so that the PWID can access his / her ART and OST at any centre. |
|
| Health-care system level barriers |
1. A “single window” system should be adopted for all ART and OST services |
1. OST timings should increase, or OST should be in two shifts for better coverage. |
| 2. ART centre timing should increase to accommodate the PWID schedules |
2. IEC material with information about benefits of OST and ART services should be available |
| 3. Preferential treatment to be given to PWIDs by having a separate queue / separate time |
3. Intensified outreach mechanism should be developed for referral and linkages. |
| 4. ART medicine should be started irrespective of their CD4 count |
4. Peer leaders who are role models should be identified and peer group committees formed for facilitation of services. |
| 5. Provision of link ART center at TI level where there is more concentration of HIV positive PWIDs. |
|
| 6. Intensified outreach mechanism should be developed for referral and linkages even beyond ART and OST services (e.g. food, shelter, social benefits, etc.) |
|
| Structural barriers |
1. Food coupon/token should be given to PWIDs to meet their nutritional requirement. |
1. Involvement of family for treatment support |
| 2. Provision of shelter with basic amenities to maintain personal hygiene |
2. Multi stakeholder involvement by advocacy with police and other local leaders. |
| 3. Involvement of family for treatment support |
3. Provision of nutritional support, medical treatment for other ailments |
|
4. Skill development, education to be provided |
