HIV Prevention Services, Capacity Building Assistance And Evaluation Activities For High-Risk, Underserved Populations In The RSA Under PEPFAR
In South Africa given the generalized nature of the HIV epidemic, prevention, treatment, care and counselling services are not well suited for key populations (KPs). In fact traditional HIV prevention messages are not necessarily relevant to KPs (i.e., they may be too focused on partners/families); or HIV messaging may not speak to the specific socio-demographics of KPs (i.e., ???Protect Yourself, Protect your Partner, Protect your Family???). For this reason public health care services tend to be geared towards members of the general population. Hence there is a need for specific HIV prevention messaging and services that is geared towards KPs. Taking into consideration the disproportionate risks of HIV infection for KPs, such as men who have sex with men (MSM), sex workers (SWs) and and persons who use illegal drugs PWUDs, including persons who inject drugs (PWIDs) such services are urgently needed.
According to the Desmond Tutu HIV Foundation (DTHF) Policy Brief on Key Populations (2011), MSM, transgender people, SWs, injecting drug users (IDUs), prisoners and migrant populations are collectively labelled ???Key Populations???. KPs exist in every region of the world, in every country, and in most communities. Because they are often marginalised by society and greatly affected by discrimination and stigma, these groups have become some of the most at-risk populations for HIV infection.
Globally, KPs have been shown to be at disproportionate risk for HIV infection. HIV prevalence within these populations tends to be higher in areas where same-sex behaviours, drug use and sex work are criminalized, and where appropriate actions addressing their specific health needs are absent. High levels of prejudice and moral loading has been shown to create barriers to accessing prevention, treatment, care and support ??? increasing vulnerability to HIV. On the contrary, the uptake, access and utilisation of services focusing on these key, marginalized populations is significantly better within environments where non-discriminatory services are provided and legal frameworks and policy provide enabling environments.
Much focus has been placed on the high HIV prevalence among women and youth in South Africa. Yet, local evidence shows that KPs are also greatly affected by HIV, and proportional to the size of these populations account for a disproportionate amount of new HIV infections ??? indicating that HIV preventions to date have not reached and benefited these individuals
KPs need to be explicitly included in the National HIV response. Without taking such marginalised groups into account, any response to HIV will prove inadequate and fruitless. In order to appropriately manage the overall HIV epidemic, the South African government, civil society, and individuals should not only consider HIV within the general population, but should also develop focused programmes that address the needs of the KPs mentioned above. The DTHF consulted service providers for KPs and other relevant stakeholders in response to the urgent need for HIV prevention initiatives tailored for KPs. In response to this the DTHF, provided recommendations and operational guidelines in a report entitled: ???Key Populations, Key Solutions: A Gap Analysis and recommendations for Key Populations in South Africa, and recommendations for the National Strategic Plan for HIV/AIDS, STIs and TB (2012-