By Michael Gwarisa
LEAVING key Populations (KPs) behind in HIV/AIDS interventions and programs poses a a threat to the ambitious target of reducing HIV prevalence, deaths and new infections by the year 2020.
In Zimbabwe, KPs mean gay men and other men who have sex with men, sex workers and their clients, transgender people and people who inject drugs as the four main key population groups, but it acknowledges that prisoners and people with Disability also are particularly vulnerable to HIV and frequently lack adequate access to services (ZNASP3 )
Briefing Journalists during a Zimbabwe Aids Network (ZAN) Workshop on Pro-Key populations budget, Policy Advocacy and Analysis, SafAids ‘s Lloyd Dembure said HIV prevalence was very high amongst KPs and they were driving the pandemic since most individuals from heterosexual relationships are engaging in sex or getting sexual services from members from these key groups.
“Globally, HIV prevalence is estimated to be 28 times higher among people who inject drugs, 12 times higher among sex workers, 19 times higher among gay men and other men who have sex with men (MSM) and Up to 49 times higher among transgender women (TW) than among the rest of the adult population (UNAIDS 2015 )
“According to latest ZNASP 3, preliminary results from the modes of transmission study, Nearly 4000 new HIV infections a year among female sex workers (with a prevalence around 57.1%). Nearly 2000 new infections each year among men who have sex with men (MSM) (with a prevalence of about 23.5%). Among prisoners, HIV prevalence is estimated at 28% (26.8% among male detainees and 39% among female detainees)” said Dembura.
He also said there were various interventions and initiatives at Global scale that have been put in place to ensure KPs access basic health care servcies. KPs also mean sub-groups of the population at higher risk of being infected by HIV, who play a key role in how HIV spread, and whose involvement is vital for an effective and sustainable response to HIV.
“There have been KP community led services – eg peer education, referral, condom and lubricants distribution. According to Condom impact modelling and gap analysis by the Clinton Health Access Initiative (CHAI) (2015) has indicated that an estimated 2 million new HIV infections were averted by the increase in actual condom use between 1990 and 2016.
“However, there is need for sustained and robust condom distribution appropriate to settings where high risk sexual activity occurs, re-enforcing the benefits of consistent and correct use of condoms and rebranding and repackaging of the public sector condoms –maDembare – strengthen peer education for adoption of safer sex practices and demand generation”
Other interventions including community systems strengthening – advocacy structures, peer groups, and networks need to be put in place.
“This provide them with space and opportunity to act together, and to campaign for their rights. KP friendly clinical and support services like HTS, STI screening and treatment and core-infections and co-infections, such as tuberculosis and viral hepatitis. There is need to increase the sites.”
Meanwhile, HIV Testing Services initiatives such as scaling up innovative and differentiated HIV testing models including lay testing, community testing, index testing and self-testing targeting high yield populations, such as sex workers need to be strengthened.