Port cities historically are entry points for diseases to enter and spread. India’s numerous and densely populated ports are geographic “hot spots” for the country’s current HIV/AIDS epidemic, which is third in the world after South Africa and Nigeria in the number of infections.

The Samastha project works in Karnataka and the coastal district of Andhra Pradesh and is one of three components under the umbrella of the $49-million Enhance Project that supports Improved Health and Reduced Fertility in Targeted Areas of India and Increased use of prevention, and care and support interventions to prevent/mitigate HIV/AIDS. It includes networked services for prevention, care and treatment through implementation and strengthening of public and private sector involvement. The activities are implemented through a consortium of NGO partners and works in close collaboration with the State AIDS Prevention Society of Karnataka (KSAPS) and Andhra Pradesh (APSACS).

The main activities focus on prevention among high risk groups and vulnerable populations; community-based care, support and treatment including voluntary counseling and testing (VCT) services for adults and children; and system strengthening at the district and state level including training and human capacity development of more than 15 local non-governmental organizations.

The project works to establish a system for building and maintaining capacity of local organizations, government institutions such as KSAPS and APSACS; and the private sector to implement HIV/AIDS programming. Capacity building activities include establishment of five regional resource training centers, organization of regional supportive supervision teams and developing a cadre of district level counselors.

Other activities are:

• Targeted interventions with female commercial sex workers primarily in nine rural districts of Karnataka, using peer outreach, provision of sexually transmitted infections (STI) services, condom promotion and working with clients;
• Interventions with other vulnerable populations like youth and migrants including men with symptoms of STI, women and men with tuberculosis(TB) in 12 rural districts of Karnataka through behavior change programs that emphasize abstinence, being faithful and condom use messages; and
• A community-based care and treatment program covering all of Karnataka and five selected coastal districts of Andhra Pradesh that aims to improve access to and use of HIV- related services including VCT services, increase coverage of programs that support orphaned and vulnerable children and enhance quality of clinical care for HIV, antiretroviral (ARV) therapy and TB management in the public and private sectors.