The WHO released its new Consolidated guidelines on HIV prevention, diagnosis, treatment and care for key populations , on 11 July 2014. These guidelines set out the priority services and interventions required to meet the needs of people who are at high risk of HIV infection: people who inject drugs, sex workers, men who have sex with men, transgender people, and people in prisons and other closed settings. In this 184-page publication – launched at AIDS 2014 in Melbourne – the WHO brings together all existing guidance relevant to key populations, and updates selected guidance and recommendations.

Five Key populations

Key populations are disproportionally affected by HIV in all countries and settings. So far, WHO had developed normative guidance separately for each of the five key populations without adequately addressing overarching issues. And the WHO global HIV guidance did not specifically consider issues relating to key populations. The Consolidated guidelines aim to address these gaps and limitations.

The Consolidated guidelines provide clear-cut definitions of key populations

Bram Langen, International Programme Officer at COC Nederland: ‘The Consolidated guidelines provide clear-cut definitions of key populations. In earlier UNAIDS documents key populations were brought up, but the definitions were multi-interpretable. This is why governments could neglect certain groups, such as men who sex with men and transgender people, when developing national strategic HIV prevention plans. The publication also contains extremely useful recommendations for developing and implementing HIV prevention plans, and clear priorities are set. Besides focusing on biomedical and behavioural interventions, the WHO guidelines emphasise the importance of structural interventions such as addressing stigma and discrimination against, for example, homosexuals and sex workers.’

Recommendations

The Consolidated guidelines provide a comprehensive package of evidence-based HIV-related recommendations for all key population, ranging from ‘The correct and consistent use of condoms with condom-compatible lubricants is recommended for all key populations to prevent sexual transmission of HIV and sexually transmitted infections (STIs)’ to ‘Countries should work towards implementing and enforcing antidiscrimination and protective laws, derived from human rights standards, to eliminate stigma, discrimination and violence against people from key populations’. A table summarises the recommendations presented in the publication (pp. xvii-xix).

Furthermore, the Consolidated guidelines aim to increase awareness of the needs of and issues important to key populations. The guidelines also intend to improve access, coverage and uptake of effective and acceptable services, and catalyse greater national and global commitment to adequate funding and services.

Target audience

The WHO guidelines are addressed primarily to national HIV programme managers and other decision-makers within ministries of health and those responsible for health  policies, programmes and services in prisons. In addition, the guidelines will be relevant  for managers at national and sub-national levels responsible for services for TB, viral  hepatitis, sexual and reproductive health, harm reduction and drug dependence, and
mental health; community-led civil society organisations and implementing programmes; and development and funding agencies.

Read the complete publication Consolidated guidelines on HIV prevention, diagnosis, treatment and care for key populations