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There is no published data from NACO about the number of FSWs receiving ART through its national program.However, positive people networks and community organizations working with FSWs report that FSWs living with HIV have limited access to free first-line ART from government ART centers.Framework analysis is particularly appropriate for applied qualitative research when a study is oriented towards policy outcomes.

India's National AIDS Control Organization (NACO) provides free first-line antiretroviral treatment (ART) at government centers for people living with HIV.

To assist in developing policies and programs to ensure equity in ART access, we explored barriers to ART access among female sex workers (FSWs) living with HIV in Chennai.

Between August and November 2007, we conducted three focus group discussions (FGDs) and two key informant interviews among FSWs recruited through nongovernmental organizations (NGOs) that provide services to FSWs in Chennai.

FGD participants were recruited using purposive sampling to reflect diversity in terms of area of residence, living situation (with family members or alone) and duration of contact with the NGO.

An honorarium of 250 Indian rupees was given to FGD participants. Interviews were tape-recorded, transcribed verbatim in Tamil, and translated into English for data analysis.

We developed a hierarchical thematic framework that we used to classify and organize data according to key themes, concepts and emergent categories.

This study aimed to identify and understand barriers faced by FSWs living with HIV in Chennai in accessing free ART provided by government ART centers.

Identifying and understanding these barriers will support the development of effective interventions to enhance access to ART among FSWs living with HIV.

One key informant was an FSW community leader of a community-based organization (CBO) and the other key informant was a former FSW with several years of experience in providing peer counseling to FSWs.

Key informant interviews focused on exploring perspectives and experiences in relation to free ART access for FSWs as well as eliciting insights on how to remove barriers to ART access.

Clearly, a major challenge for government ART centers is to expand access to free ART.

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