Tagged: key populations

  • One size doesn’t fit all: Why differentiated services are still needed for the next phase of the HIV response

    Over the past decade, there have been remarkable advances in the HIV prevention, treatment and epidemic control tools used by the global community working to address HIV. Investments in scientific discovery and implementation research have furthered our understanding of the factors driving the epidemic, as well as the biology of viral transmission. Prevention, diagnostic and treatment strategies have improved immensely, as have antiretroviral drugs. 

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  • Pandemic preparedness: Four strategies to keep HIV programs on track during COVID-19

    A little more than a month after World AIDS Day 2019, COVID-19 started to impact our HIV programs in Asia as countries like Cambodia, Thailand and Vietnam began quarantine. Community testing ground to a halt. People living with HIV worried about access to their medications. HIV pre-exposure prophylaxis (PrEP) enrollment slowed. COVID-19 testing diverted laboratories from HIV services. By March 2020, the rest of the world was equally impacted. FHI 360’s HIV programs were determined to continue serving people, but there were deep concerns. We were not alone, of course; the global HIV community was facing COVID-19 together. But with so much uncertainty, we wondered: Would COVID-19 substantially set back hard-won gains toward epidemic control? Did we have the tools in hand, or could we develop the tools, to weather this crisis?

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  • New journal supplement on key populations is here!

    A version of this post originally appeared on the LINKAGES blog. Reprinted with permission.

    JIAS July 2018 issue coverThe USAID– and PEPFAR-supported LINKAGES project is excited to announce the arrival of a new supplement in the Journal of the International AIDS Society (JIAS) titled Optimizing the Impact of Key Population Programming Across the HIV Cascade.

    A collaboration among LINKAGES, USAID, CDC, amfAR, and JIAS, this supplement contributes new evidence and data-driven strategies for improving programming with men who have sex with men, sex workers, transgender people and people who inject drugs. It contains 14 original articles that represent a range of multidisciplinary efforts from diverse geographies to advance key population science and practice across the HIV prevention, care and treatment cascade.

    As HIV services are scaled up in pursuit of 90-90-90 targets, investments to address the epidemic among key populations must be central to these efforts. Global data indicate that gains made among key populations lag substantially behind those made in the general population. This supplement aims to accelerate progress toward controlling the epidemic by bringing visibility to new evidence and approaches that can make key population programming smarter and more effective.

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  • A future without AIDS begins and ends with key populations

    A version of this post originally appeared on the LINKAGES blog. Reprinted with permission.

    “We will only achieve HIV/AIDS epidemic control if we reach the UNAIDS 90-90-90 targets for all ages, genders, and at-risk groups, including key populations.”

    – Ambassador Deborah L. Birx, MD, U.S. Global AIDS Coordinator and U.S. Special Representative for Global Health Diplomacy, June 2018

    In 2013, UNAIDS set out to establish new global targets for HIV testing, care and treatment. Stakeholder consultations were conducted at country and regional levels around the world, ultimately resulting in the creation of the ambitious 90-90-90 targets to help bring an end to the AIDS epidemic:

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  • Three ways to turn science into practice to reduce HIV among key populations

    Later this month, leading scientists and cutting-edge thinkers will gather at the International AIDS Society’s 9th IAS Conference on HIV Science in Paris to discuss the latest scientific discoveries in HIV prevention, care and treatment. These discoveries hold the potential to accelerate progress toward the global 90-90-90 targets set forth by the Joint United Nations Programme on HIV/AIDS (UNAIDS). And, they are especially important for key populations — including men who have sex with men, sex workers, transgender people and people who inject drugs — who shoulder a disproportionate burden of HIV. UNAIDS estimates that 45 percent of all new HIV infections among adults worldwide occur among these key populations and their sex partners. Reaching these groups with new technologies and approaches is essential to ending the epidemic.

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  • Srey Sros: Addressing the needs of transgender populations in Cambodia

    Srey Sros model

    A transgender model promotes the Srey Sros program. Photo: Graphic Roots Studio, Cambodia

    I have three long-haired boys, and wherever we go in Cambodia, people are confused, certain they are girls. We are constantly asked, “Why?” The answer is simple: They like having long hair. My boys’ push against traditional gender expressions is perhaps acceptable only because Cambodians have come to expect odd behavior from foreigners.

    Yet, it is a different matter for a Cambodian transgender individual with long hair. Transgender individuals in this setting face many acute challenges, and their unconventional appearance is only one of them.

    Transgender individuals in Cambodia carry a high burden of HIV. According to a study conducted by FHI 360 in select urban centers of the country, transgender individuals have an HIV prevalence of 4.15 percent (compared to 0.6 percent for the general population). Despite this striking percentage, they have historically been left out of HIV prevention and care programs. When they were included, they were incorrectly targeted as men who have sex with men. This means that there were no distinct behavior change communications or services for this group.

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  • Inextricable links: HIV and human rights

    The AIDS epidemic has been characterized by the stigma and discrimination of people who are all too often already on the margins of society.

    This marginalization has made it more difficult for millions of people on every continent to access much-needed HIV prevention, treatment, care and support services. As we recognize International Human Rights Day on Dec. 10, we cannot lose sight of the inextricable link between HIV and human rights, which should be the cornerstone of our response to and understanding of this epidemic.

    And there is, perhaps, reason for cautious optimism. Despite some policy gains and increased global attention, HIV continues to disproportionately affect “key populations” — men who have sex with men, sex workers, people who inject drugs and transgender people. UNAIDS estimates that 40 to 50 percent of new adult HIV infections worldwide occur among key populations and their partners.

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  • Research on key populations leads Botswana to smarter HIV prevention

    At approximately 18 percent, the prevalence of HIV in Botswana’s general population is one of the highest in the world. As a result, national HIV prevention efforts have focused more intensively on the general population than on other populations. Little is known about key populations, such as female sex workers and men who have sex with men, whose behaviors are both stigmatized and illegal in Botswana.

    In 2012, the Botswana Ministry of Health used an integrated behavioral and biological surveillance survey to estimate population sizes and prevalence of HIV and sexually transmitted infections (STIs) among female sex workers and men who have sex with men. The study was historic. For the first time, it showed the HIV and STI burden among these two key populations and raised awareness about how they might have contributed to the generalized HIV epidemic.

    The survey, carried out with technical assistance from FHI 360 through the Preventive Technologies Agreement (funded by the U.S. Agency for International Development), uncovered a population of more than 4,000 female sex workers in the three districts where the survey was conducted. Among these female sex workers, HIV prevalence was 61.9 percent, and the prevalence of gonorrhea and chlamydia were both higher than 10 percent. The female sex workers had a mean of more than seven partners per week, and condom failure, which includes condom breakage and being paid or forced not to use condoms, was common.

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  • Focusing on key populations affected by HIV: A smart investment for greater impact

    In an era of limited resources, HIV prevention, care and treatment efforts need to focus on the smartest investments. This means investing in programs that can have the greatest impact in halting HIV transmission and turning back the epidemic. From a public health perspective, the effective use of resources requires focusing on key populations who have the highest level of HIV infection and tackling the barriers that discourage and prevent them from accessing health systems and services. These populations are broadly defined as sex workers, men who have sex with men, transgender persons and persons who inject drugs.

    As the world gathers at the 20th International AIDS Conference (AIDS 2014) in Melbourne, Australia, July 20–25, 2014, we have an excellent opportunity to share how investing in evidence-based strategies can change the trajectory of the epidemic once and for all.

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