Expanding access to holistic care for people living with HIV in India

Now 16, he receives support from a team of doctors and counselors who have shown him that survival is not just about taking pills, but about finding reasons for hope.

Sameer is a patient at Guru Gobind Singh Hospital in Patna, a city in India’s Bihar state, where Doctors Without Borders/Médecins Sans Frontières (MSF) provides holistic care for advanced HIV. Patients with advanced HIV have an extremely high mortality rate, with complex treatment needs including nutrition, infection, mental health, and psychosocial support.

Sameer, an HIV patient in India, sits in a chair.

Sameer*, a patient living with advanced HIV, talks to a counselor at the Guru Gobind Singh Hospital in Patna, Bihar.

Sameer* talks to counselor Meena Kumari at MSF's advanced HIV care center at Guru Gobind Singh Hospital in Patna. India 2025 © Deepak Bhatia/MSF

Despite these critical medical needs, seeking even basic health care can be a challenge for people living with HIV in Bihar. Many fear rejection from society, family, and friends due to social stigma, and the financial costs can be prohibitive, especially for those who are unemployed due to their condition. Patients often must bear the high costs of private care, which can result in significant mental health burdens that impact their ability to access proper diagnosis and treatment, and to adhere to their treatment regimens.

To reduce mortality and morbidity, MSF has been working in collaboration with the Indian government to expand access to holistic care for people with life-threatening infections like HIV.

Dr. Aatika examines a patient's CT scan at MSF's advanced HIV care center in India. — Dr. Aatika examines a patient's CT scan at MSF's advanced HIV care center. | India 2025 © Deepak Bhatia/MSF

Distance and stigma create huge barriers to care

To reach the MSF clinic in Bihar, Sameer walks a mile from his village, then takes a boat and an auto-rickshaw to Guru Gobind Singh Hospital. The journey takes about three to four hours.

Sameer was diagnosed with HIV as a young child and started antiretroviral treatment following the death of both of his parents from the same disease. Under the care of family members, he struggled to take his medication consistently and did not attend school.

[Patients] don’t have money to go to the right place for proper treatment. When we go [into communities], we give them complete information.
Fareed, MSF lay counselor in Bihar

When his health worsened in 2021, he was referred to MSF for specialized care. For a month, doctors, nurses, and counselors provided Sameer with medical treatment and emotional support. He admitted that he had not been taking his medication properly. The MSF team helped him understand the importance of regular treatment and supported him with care and encouragement.

But after his discharge, Sameer’s health declined again. During a home visit, the patient support team found that Sameer had again been hiding his medicines without taking them regularly. He said he doubted that the medicine would work because his parents had died despite taking antiretroviral drugs. As a result, Sameer was admitted to the MSF ward for the second time..

MSF’s patient support program provides people with the knowledge to manage their health and seek care when needed. We also provide mental health care to address the emotional toll of the disease and its associated stigmas, helping patients overcome the sense of hopelessness that many face.

Nisha*, patient living with HIV

“There is hope, and there is life beyond the diagnosis”

Living with HIV has been a difficult journey, but it has also taught me a lot about strength, hope, and the importance of support.

I first started feeling very unwell with fever, coughing, vomiting, and losing weight. I went to hospitals in Samastipur and Darbhanga, but the treatment did not help. Finally, when I came to MSF’s advanced HIV care center, I was diagnosed with HIV. I was scared and worried about what this meant for me and my family.

At first, I felt very alone. People around me, even some family members, kept their distance. The stigma was painful. Neighbors and relatives avoided us, and my shop suffered because of rumors. I had to close it for some time. But over time, with education and awareness, many people’s attitudes changed.

The kindness of the hospital staff — the doctors, nurses, and counselors — gave me hope. They treated me with respect and dignity and helped me understand how to live with HIV.

MSF’s patient support program taught me how to manage my health, take my medicines on time, and not lose hope. They also helped my family understand my condition better, reducing fear and discrimination at home.

Living with advanced HIV is not just a physical challenge; it affects your mind and spirit too. The mental health support I received was critical in helping me face my fears, the stigma, and the uncertainty. MSF’s team worked closely with me and my family to provide counseling and education. This support helped me to overcome despair and regain control of my life. It showed me that I am not alone and that with the right care, I can live well.

Sometimes, it feels overwhelming, but the support I received here made all the difference. I learned that HIV is a medical condition, not a curse or a punishment. With the right treatment and care, I can live a normal life, care for my daughters, and even run my shop again.

I want others who are newly diagnosed with HIV to know that they are not alone. There is help available, and with proper treatment and support, they can live well. I encourage everyone to come forward for testing and treatment without fear. The MSF team here in Bihar has shown me that care is not just about medicines, but about understanding, compassion, and empowerment.

My daughters are my motivation. I want them to study, grow, and have bright futures. I want to live for them and show that HIV does not define who I am. If you or someone you know is living with HIV, please remember: Take your medicines on time, eat well, and seek support. There is hope, and there is life beyond the diagnosis.

Spreading awareness to promote health

Community awareness is an important part of MSF’s work treating HIV in Bihar. “[Patients] don’t have money to go to the right place for proper treatment,” says Fareed, a lay counselor educator with MSF’s HIV/AIDS program. “When we go [into communities], we give them complete information.”

There is no cure, but I can stop transmission through awareness. As long as I’m here, my effort will be to prevent this disease from spreading and save people’s lives.
Fareed, MSF lay counselor in Bihar

Fareed trains Accredited Social Health Activist (ASHA) workers at community health centers to identify suspected cases and confidentially inform authorities so families can be protected from stigma and discrimination. He also raises awareness about HIV/AIDS among patients and caregivers.

“There is no cure, but I can stop transmission through awareness,” Fareed adds. “As long as I’m here, my effort will be to prevent this disease from spreading and save people’s lives.”

*Names changed to protect privacy