New guidelines stress increasing key populations’ access to HIV services

WHO/James Hammond

Coverage in the eastern part of the Region increased from 23% of all people with HIV in need of ART (129 000) in 2010 to 35% (199 000) in 2012. Nevertheless, relatively few eligible people were starting ART and achieving viral suppression at that time. As a result, the numbers of AIDS cases and deaths in this part of the Region have increased by 47% and 13%, respectively, since 2010.

Countries need to remove legal and social barriers that prevent many people from accessing services for HIV testing, treatment and care, according to new WHO guidelines.

The “Consolidated guidelines on HIV prevention, diagnosis, treatment and care for key populations” outline steps for countries to take in reducing new infections and increasing access to services for five key populations: men who have sex with men, people in prison, people who inject drugs, sex workers and transgender people. Failure to provide adequate services to these groups threatens regional and global progress in responding to HIV.
WHO launched the guidelines at the 20th International AIDS Conference in Melbourne, Australia, which opened on 20 July.

Increased use of antiretroviral therapy in European Region

The guidelines are published as new figures underline the need for continued global progress against HIV. The use of antiretroviral therapy (ART) has increased across the WHO European Region. Although no low- or middle-income country has yet made sufficient progress to achieve the target of 80% ART coverage worldwide by 2015, the number of people receiving ART has increased considerably.

Coverage in the eastern part of the Region increased from 23% of all people with HIV in need of ART (129 000) in 2010 to 35% (199 000) in 2012. Nevertheless, relatively few eligible people were starting ART and achieving viral suppression at that time. As a result, the numbers of AIDS cases and deaths in this part of the Region have increased by 47% and 13%, respectively, since 2010.

In the western part of the Region, the number of people receiving ART was high (560 000) and most countries have achieved or are expected to achieve the 2015 target.

Gaps in national HIV plans on needs of key groups

Across the Region, preventive efforts still lag too far behind the needs, particularly among key populations. National HIV plans still show significant gaps in addressing the needs of key populations, who are less likely to have equal access to treatment.

For example, in some places in eastern Europe, people who inject drugs make up more than half of all people living with HIV, but only a third of the latter have access to lifesaving ART. In many countries, laws that criminalize sexual behaviour, drug use, gender expression or perceived sexual orientation reinforce discrimination. Further, the risks of HIV infection can be 50 times higher for people who inject drugs than the general population, according to modelling estimate studies.

WHO/Europe will start disseminating the new guidelines in the Region in August 2014, in both English and Russian.