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Technical Bulletin Compendium: HIV Prevention and Treatment Strategies for MSM

Intended as a primer for MSM advocates and service providers, this series covers key interventions and frameworks that have been central to the current global dialogues on HIV prevention, treatment and care. Topics were identified and prioritized based on results of the MSMGF’s 2010 Global Men’s Health and Rights study (GMHR), which surveyed more than 5,000 MSM worldwide regarding access to and knowledge of the current spectrum of HIV prevention strategies. Each bulletin was developed utilizing a balanced approach, highlighting both the benefits and challenges of a given intervention based on existing evidence.

Media:

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The Global HIV Epidemics among Sex Workers

Since the beginning of the epidemic sex workers have experienced a heightened burden of HIV. Unfortunately, sex workers’ HIV and health-related risks and rights have often gone unattended and global resource allocation related to HIV prevention, treatment and care has not been based on rigorous analysis in terms of the evidence related to sex work and HIV. To inform an equitable, effective, and sustainable response to HIV which promotes and protects the human rights of sex workers, the following questions were addressed in this analysis, focusing largely on female sex workers from lower and middle income countries:

What is the global burden of HIV among sex workers? How do sex worker HIV burdens compare to the general population? How does this vary by region?
How does the policy and social context shape sex workers’ HIV risk across geographic settings? How does this context influence the provision and coverage of HIV services?
To what extent can comprehensive HIV prevention at-scale among sex workers modify HIV transmission dynamics among sex workers and the general population?
What are the most cost-effective HIV prevention, treatment, and care interventions in the context of sex work? What combinations of services are most cost-effective?
Given this evidence, what are the implications for allocative efficiency in HIV prevention programs?
How does violence against sex workers affect their health and human rights and HIV transmission dynamics among sex workers and the general population across settings?
What has been the role of sex worker leadership in promoting the human rights of and reducing the burden of and risks for HIV infection among sex workers across contexts?

Prevention and Treatment of HIV and other Sexually Transmitted Infections for Sex Workers in Low- and Middle-income Countries: Recommendations for a Public Health Approach

Sex workers in many places are highly vulnerable to HIV and other sexually transmitted infections due to multiple factors, including large numbers of sex partners, unsafe working conditions and barriers to the negotiation of consistent condom use. Moreover, sex workers often have little control over these factors because of social marginalization and criminalized work environments. Alcohol, drug use, and violence in some settings may further exacerbate their vulnerability and risk.

The objective of this document is to provide technical recommendations on effective interventions for the prevention and treatment of HIV and other STIs among sex workers and their clients. The guidelines are designed for use by national public health officials and managers of HIV/AIDS and STI programmes, nongovernmental organizations including community and civil society organizations, and health workers. Regions and countries are encouraged to adapt these guidelines to support acceptable services for sex workers taking into account the epidemiological and social context. These guidelines may also be of interest to international funding agencies, the scientific media, health policy-makers and advocates.

Year of publication:

2012

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Consultation of Sex Workers (PICO Questions) and Report

The World Health Organization (WHO) is developing guidelines for evidence-based interventions for the prevention and treatment of HIV and other sexually transmitted infections (STIs) in low- and middle-income countries. As a global partner to the WHO in this process, the Global Network of Sex Work Projects oversaw a civil society consultation of sex workers commissioned by the WHO to gather feedback on proposed guidelines. This report contains the findings from that consultation and was submitted to the WHO.

Media:

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‘SWIT’ – Implementing Comprehensive HIV/STI Programs with Sex Workers (Policy Brief)

This tool, commonly abbreviated as ‘SWIT,’ is the product of collaboration among sex workers, service providers, researchers, government officials, and NGOs from around the world. Its development was guided by WHO, UNFPA, UNAIDS, NSWP, the World Bank, and development partners from the US, including the Bill & Melinda Gates Foundation. The purpose of this tool is to describe approaches and principles to building programmes. Guidance is provided on how to implement the recommended health-care interventions for HIV prevention, treatment and care, how to manage programmes, and how to build the capacity of sex worker organizations. Throughout the document are case examples from programmes around the world, highlighting specific aspects related to sex worker programming that have worked well in their contexts. These case examples illustrate how an issue or challenge has been addressed, and to inspire ideas about approaches that could work in the reader’s own context.

The full-text document is also available.

Year of publication:

2013

Media:

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Consolidated Guidelines on the Use of Antiretroviral Drugs for Treating and Preventing HIV Infection: Recommendations for a Public Health Approach

These consolidated guidelines provide guidance on the diagnosis of HIV infection, the care of people living with HIV, and the use of antiretroviral (ARV) drugs for treating and preventing HIV infection. They are structured along the continuum of HIV testing, care and treatment. Behavioural, structural and biomedical interventions that do not involve the use of ARV drugs are not covered in these guidelines. The 2013 consolidation process combines and harmonizes recommendations from a range of WHO guidelines and other documents, including the 2010 guidelines on using antiretroviral therapy (ART) for HIV infection in adults and adolescents, in infants and children, and for treating pregnant women living with HIV and preventing HIV infection in infants. Comprehensive guidance is now provided on using ARV drugs across age groups and populations of adults, pregnant and breastfeeding women, adolescents, children and key populations. The guidelines also aim to consolidate and update clinical, service delivery, and programmatic guidance.

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Civil Society and Key Populations and the Country Dialogue Process, Guidance Note: Navigating the New

This guidance document, the second in the series Navigating the New Funding Model, is intended as a tool for civil society organizations which are engaged in, leading, or monitoring country dialogues. An explanation of the key features and expected outcomes of the country dialogue process is followed by a discussion of country dialogues in practice over the past year. A review of existing analyses and interviews with civil society participants in country dialogues inform a discussion of the principles of effective country dialogues. For the purposes of this document, “effective” country dialogues are those which include significant and meaningful civil society and key population participation and inform a concept note which reflects the true nature of a country’s epidemics and an inclusive strategy for combating them.

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UNAIDS Guidance for Partnerships with Civil Society, Including People Living with HIV and Key Populations

This document provides guidance on how The Joint United Nations Programme on HIV/AIDS (UNAIDS), its Cosponsors and Secretariat (working at national, regional and global levels) should strengthen and operationalize meaningful and respectful partnership work with civil society. It should enable the UN to deliver the targets and elimination commitments agreed in the 2011 Political Declaration on HIV/AIDS. It assumes that putting partnerships into practice will take place in the context of Getting to Zero (UNAIDS Strategy 2011–2015) and be supported by the Unified Budget, Results and Accountability Framework (UBRAF)—which is, in essence, the UNAIDS work plan to deliver on Getting to Zero—as well as other key UNAIDS programming and budgeting documents.

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