Most at risk HIV people not getting health services

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WHO Logo

Accra, July 11, GNA – Failure to provide adequate HIV services for key groups threaten global progress on the HIV response, warns the World Health Organization (WHO).

According to WHO,   the key groups cover men who have sex with men, people in prison, people who inject drugs, sex workers and transgender people.

The WHO on Friday released ‘Consolidated Guidelines on HIV Prevention, Diagnosis, Treatment and Care for Key Populations,’ which was made available to the GNA by Glenn Thomas, WHO Communications.

It said these people are at risk most of HIV infection, yet are least likely to have access to HIV prevention, testing and treatment services.

The Report said in many countries they are left out of national HIV plans, and discriminatory laws and policies are major barriers to access.

The publication is a prelude to the International AIDS Conference in Melbourne, Australia, starting on July 20.

The guidelines outline steps for countries to reduce new HIV infections, and increase access to HIV testing, treatment and care for these five ‘key populations.’

They include a comprehensive range of clinical recommendations, but for these to be effective, WHO also recommends that countries need to remove the legal and social barriers that prevent many people from accessing services.

For the first time, WHO strongly recommends men who have sex with men, to consider taking anti- retroviral medicines as an additional method of preventing HIV infection (pre-exposure prophylaxis), alongside the use of condoms.

It said rates of HIV infection among men who have sex with men remain high almost everywhere, and new prevention options are urgently needed.

It said modelling estimates that, globally, 20-25 per cent reductions in HIV incidence among men who have sex with men could be achieved through pre-exposure prophylaxis, averting up to one million new infections among this group over 10 years.

The publication said studies indicate that women sex workers are 14 times more likely to have HIV than other women, men who have sex with men are 19 times more likely to have HIV than the general population, and transgender women are almost 50 times more likely to have HIV than other adults.

It observed that for people who inject drugs, studies show the risks of HIV infection could be also 50 times higher than the general population.

‘None of these people live in isolation,’ said Dr Gottfried Hirnschall, Director of the HIV Department at WHO.  

  ‘Sex workers and their clients have husbands, wives and partners. Some inject drugs. Many have children. Failure to provide services to the people who are at greatest risk of HIV, jeopardizes further progress against the global epidemic and threatens the health and well being of individuals, their families and the broader community.’

The guidelines are published as new figures underline the need for continued global progress on HIV.

According to it, by the end of 2013, around 13 million people were taking anti-retroviral therapy, with 11.7 million of these people living in low and middle-income countries.

It said this has led to a 20 per cent drop in HIV-related deaths between 2009 and 2012, but while the number of people dying of AIDS is falling sharply, preventive efforts are still lagging too far behind, particularly among key populations.

It said there are still significant gaps in addressing their needs in national HIV plans, adding that globally, just 70 per cent of countries surveyed, explicitly address the needs of men who have sex with men and sex workers, while the figure for injecting drug users is 40 per cent.

It said in many countries, discrimination is reinforced by laws that criminalize sexual behaviours, drug use, gender expression or perceived sexual orientation.

However, where laws and policies support access to HIV services for these key populations, illness and death due to HIV among these groups, had declined and new HIV infection rates remain low or have fallen, especially among sex workers and for people who inject drugs.

These new guidelines outline ‘comprehensive HIV packages’ for prevention, diagnosis, treatment and care for the five key populations and address specific issues and needs of adolescents from these groups.

These include, measures to better manage sexual and reproductive health, mental health and co-infections such as tuberculosis and hepatitis.

They highlight the need for needle and syringe and opioid substitution therapy programmes, and include recommendations for treatment of overdose in the community.

At the 2014 International AIDS Conference in Melbourne, WHO will call on governments to re-energize and strengthen HIV programmes so that all key populations benefit from the on-going advances in HIV treatment and programme scale-up.


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