Despite efforts to eliminate HIV, levels remain high among key populations, with UNAIDS estimating that globally men who have sex with men (MSM), people who inject drugs (PWID) and female sex workers (FSW) have three to 11 times higher burden of HIV infection and contribute to the majority of new HIV infections. The £5 million award will fund an eight-year study to improve current prevention strategies for these key populations.
While existing HIV prevention interventions work for key populations, "structural factors", such as unemployment, homelessness, stigma, violence and criminalisation, may severely limit their impact. These factors are pervasive in key populations globally and can increase the vulnerability of key populations to HIV through reducing access to health services, retention to HIV treatment, and increasing HIV risk behaviours.
Although largely overlooked in the past, initiatives to reduce structural factors and their effects are a focus of recent global HIV elimination strategies, but there is limited evidence to show why it is essential to bring these to the forefront of HIV prevention efforts and how this could be achieved.
The project will include systematic reviews, epidemiological analyses, mathematical modelling and cost-effectiveness analyses, to quantify and cost the contribution of structural factors to driving the HIV epidemic, and the impact of interventions that address them. The project aims to enable evidence-based planning in HIV programming for key populations including structural interventions.