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Men Holding Hands In Mozambique

Key Populations

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PEPFAR’s commitment to reaching key populations and linking them to non-discriminatory HIV prevention, testing and treatment services remains strong.

In Fiscal Year 2018, PEPFAR reached more than 10.6 million members of priority populations and more than 4.2 million members of specific key populations with HIV prevention packages. Key populations include men who have sex with men, transgender individuals, sex workers, people who inject drugs (PWID), and people in prisons and other closed settings. PEPFAR also supported over 22,000 PWID with Medicated Assisted Treatment.

During the 2018 International AIDS Conference, PEPFAR announced over $360 million in key populations investments for the next year, including $260 million through PEPFAR’s 2018 Country Operational Plans and $100 million previously committed through the Key Populations Investment Fund [642 KB].

PEPFAR and the Elton John AIDS Foundation continue to partner on the $10 million LGBT Fund, which launched its first grants at the 2016 International AIDS Conference. As of July 2018, the Fund, created to address human rights violations, stigma, discrimination and violence faced by lesbian, gay, bisexual and transgender (LGBT) people and strengthen local organizations, has reached nearly 60,000 LGBT people in several Sub-Saharan African countries and the Caribbean through targeted, community-level projects.

PEPFAR has focused on responding to the significant unmet need for comprehensive prevention, care, and treatment programs and services among key populations globally, and has targeted efforts at the local and national level. In these efforts, it is essential to address socio-structural factors, such as stigma (including from health care workers), discrimination, violence, and law enforcement harassment, as well as harmful laws and policies that create barriers to key populations accessing HIV services and limit the effectiveness of service delivery. 

While strides have been made in some settings to strengthen HIV clinical and community services serving key populations, size estimates are frequently inaccurate, and there is a lack of adequate resources invested in programs to address social and structural issues that inhibit access to and retention in quality HIV services. 

PEPFAR has identified a number of possible solutions to help address some of these barriers, including the use of peer outreach approaches and social network strategies to increase the effectiveness and efficiency of case-finding, better training of health care workers, and the availability of Pre-Exposure Prophylaxis (PrEP).

PEPFAR contributed to the updating of the PLHIV Stigma Index 2.0 , which is currently being implemented in a number of PEPFAR-supported countries to better understand the impact of stigma on different sub-populations, especially key populations.

U.S. Department of State

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