Reaching Key Populations: Essential to Achieving an AIDS-Free Generation

Posted by Eric Goosby
June 20, 2013
Students Attend International AIDS Day Event in Cambodia

On June 18, the State Department commemorated 10 years of the U.S. President’s Emergency Plan for AIDS Relief’s (PEPFAR) support to the global AIDS response, and its contributions toward achieving an AIDS-free generation.  During the event, Secretary of State John F. Kerry highlighted the importance of reaching those most vulnerable to HIV, and announced the first recipients of targeted grants to reach key populations, including men who have sex with men (MSM), sex workers (SW), and people who inject drugs (PWID). 

Announced by Secretary of State Hillary Rodham Clinton during last year’s International AIDS Conference (AIDS 2012), the PEPFAR Key Populations Challenge Fund was established to support country-led plans to expand high-impact comprehensive packages of interventions and services for key populations.  A total of $20 million will be leveraged as PEPFAR country teams contribute funds through their country and regional operational plans. 

Six PEPFAR countries (including four in Sub-Saharan Africa) – Cambodia, Ghana, Nepal, Senegal, Swaziland, and Zimbabwe – and two regional programs – Asia and Central America – will be awarded grants through the Fund.

Key populations typically have HIV prevalence rates that exceed those of the general population.  In low-and middle-income countries in all regions of the world, recent studies reveal that HIV disproportionately affects these communities.  For example:

·        MSM were found to be 19 times more likely to be living with HIV than people in the general population;

·        Female SW were 13.5 times more likely to be living with HIV when compared to other females of reproductive age in the general population; 

·        Globally among PWID, 16 million individuals report injection drug use, and there are an estimated three million PWID living with HIV.

There are many barriers that contribute to these higher HIV prevalence rates among key populations.  Stigma, discrimination, and fear of violence or legal sanctions are among the obstacles that often undermine access to health care – including essential HIV services – by key populations.  Breaking down these barriers is essential to a robust and comprehensive AIDS response, which is why the U.S. prioritized reaching populations at greatest risk in the PEPFAR Blueprint: Creating an AIDS-free Generation.

A core principle of PEPFAR’s effective public health response to global AIDS centers on our ability to engage individuals at elevated risk of acquiring or transmitting HIV.  PEPFAR programs are designed to ensure that all individuals have access to appropriate and nondiscriminatory HIV prevention, care, and treatment services, in order to have the maximum possible impact on the epidemic while respecting human rights. 

The Key Populations Challenge Fund will allow PEPFAR teams in the field to accelerate their work hand-in-hand with partner country governments, civil society, multilateral organizations, and other donors, such as the Global Fund to Fight AIDS, Tuberculosis and Malaria, in order to overcome barriers to service access and strengthen sustainable programs and high-impact interventions.   PEPFAR will also continue its commitment to promote an enabling environment of supportive laws, regulations, policies and social norms to facilitate meaningful access to HIV services at both health facilities and at the community-level. 

Through the Key Populations Challenge Fund, we can move one step closer to providing the treatment, care, and support that are essential to reaching key populations and to achieving an AIDS-free generation.

About the Author: Ambassador Eric Goosby is the U.S. Global AIDS Coordinator and head of the State Department's Office of Global Health Diplomacy.


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