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According to the latest National Family Health Survey (NFHS) and District-Level Household Survey (DLHS) data, an average of 15 percent of the population that seeks healthcare services in Uttar Pradesh (UP) accesses government health facilities, while 85 percent opt for private providers. Although the reasons for this are multi-faceted, and include lack of confidence in the government health system, the practice has been formed over decades. The implications for HIV prevention, care, and treatment programs are great because, despite recent efforts to encourage private sector participation, the majority of services are largely located within the government health infrastructure.

Uptake of preventive health services is low in the state, especially among rural and uneducated women. Low literacy and lack of awareness about services, schemes, and entitlements, low status of women, poverty, and cultural factors are among the crucial factors that determine the health-seeking behavior in the state.1 Lack of integration of HIV services into the private sector further limits access, especially for women and children whose attitudes and practices have been formed by negative past experiences in accessing general health services at government facilities.