Risk-based Segmentation of KPs:

Below are presented the five segments. Each has a corresponding SBC package.
In Aastha, a new KP is a newly registered KP in the project who immediately becomes entitled to all Aastha services. Her risk profile is not known with the outreach at this stage and correct intervention may help her stay STI/HIV negative. Consequently, a revised SBC minimum package has been prepared, which sensitizes KPs on her options.
Aastha Ambassadors are KPs who show spontaneity of health seeking behavior, visit the clinic every month for a period of six months with a STI/HIV negative status, participate in at least three out of six Aastha Gat meetings in six months, take regular HIV testing every three months and manage a condom depot. Celebrating their health seeking behavior, these KPs are given the title of an ‘Ambassador’ or ‘Rajdoot’. As the name suggests, Aastha Ambassadors also regularly advocated about Aastha services with other KPs & stakeholders, and could also provide support through Aastha Tatkal Seva, a community led support service during crises, at least twice in six months/attend exposure visits/has a Saving Account in any bank.
KPs, who make consecutive clinic visits (at least once in two months) with no STI symptoms, show no substance abuse, maintain a healthy diet, a low transaction frequency, use condom in most transactions, undergo regular HIV testing and show active participation as the Aastha Gat member, fall under the category of ‘Low Risk’. A KP who shows the above criteria represents what may be considered ‘safer’ behavior, which takes him or her away from HIV/STI.
The profile of the High Risk KP includes repeated clinic visits with STI, a symptomatic visit following an asymptomatic one and a higher RPR titer (for Syphilis) than the previous clinic visit. Apart from the clinic profile, the high risk KP may also show risk taking behavior such as irregular condom use, high transaction frequency, substance abuse, irregular eating habits and poor health and living conditions, among others. A high risk KP may include a PLHIV KP, whose status is not disclosed with the outreach team.
An HIV positive KP has specific needs that are usually addressed by the Counselor. However, PLHIV KPs are encouraged to disclose with the outreach team. Within the PLHIV group, Aastha encourages PLHIVs to evolve themselves as Ambassadors too. PLHIV Ambassadors are more amenable for care and support services and ART registration. They undergo CD4 testing once in every 6 months, attend PLHIV support group meetings every month, manage a condom depot, regularly advocate with other KPs, visit the clinic every month for a period of six months and participate in three out of six Aastha Gat meetings in six months.

Separate SBC packages, with corresponding focus on key messages, were developed based on the risk segments. Risk based segments are placed at different positions where the continuum of HIV/STI transmission risk is concerned. Thus, for a low risk KP the stress is on staying negative, while for a high risk KP the key message focuses more on the importance of regular HIV testing and condom use. Moreover, there are SBC materials which focus specifically on reducing stigma and discrimination, and encourage positive community engagement with Aastha Gats.