In July 2022 the WHO published new guidelines on “HIV, viral hepatitis, and STI prevention, diagnosis, treatment, and care for key populations”. These guidelines were officially launched at the AIDS 2022 Conference in Canada.  

The guidelines outline a public health response to HIV, viral hepatitis, and STIs for 5 key populations: 

  • Men who have sex with men (MSM) 
  • Trans and gender diverse people 
  • Sex workers 
  • People who inject drugs 
  • People in prisons and other closed settings 

Erika Castellanos, Director of programmes at the global Action for Trans Equality (GATE) emphasised the importance of prioritising these key populations “in every setting”. She hopes to “reach them first with prevention, testing, and treatment”, prioritising them in funding programmes.  

For these populations, “social, legal, structural, and other contextual factors” increase vulnerability and “obstruct access” to essential services. The new guidelines address the importance of identifying and trying to overcome structural barriers.  

Dr Meg Doherty, the Director of WHO’s Global HIV, Hepatitis, and STI Programmes commented on recent data from UNAIDS: 

“around 70% of new HIV infections occur among key populations and their partners.” 

She identifies “limited access, inadequate coverage, and poor quality of services” that undermine HIV, hepatitis, and STI responses globally.  

The guidelines also offer recommendations for service delivery, such as online interventions and peer navigators, who will “guide members of key population groups through health services”. Other recommendations include “addressing chemsex”, increasing HCV testing for people at risk of infection, and providing immediate HCV treatment to newly infected patients.  

As data emerge from UNAIDS that reveal Covid-19’s detrimental effect on other health crises these recommendations are timely. Will they have a tangible effect, or will these populations continue to suffer higher infection rates?