Protecting key populations from abrupt disruptions to essential HIV services

Prevention, testing and treatment services for HIV, viral hepatitis and sexually transmitted infections (STI) have driven unprecedented progress in improving population health over the past two decades, with millions of new HIV infections and AIDS-related deaths averted.

Foreign aid investments in the global HIV response, such as the United States President’s Emergency Plan for AIDS Relief (PEPFAR) and the Global Fund on AIDS, TB and Malaria, have been pivotal to this success, also contributing significantly to progress towards elimination of hepatitis B and C, and STI control. However, abrupt disruptions to foreign aid and service delivery threaten these gains, putting millions of people at risk – especially people living with HIV and key and vulnerable populations.

Many essential evidence-based prevention interventions, including HIV pre-exposure prophylaxis (PrEP), harm reduction services for people who inject drugs, and community-led programmes have been permanently halted.

Early reports shared with WHO indicate that prevention and treatment services for key populations are those most affected. Reports include the closure of health centres delivering prevention, testing and treatment interventions for key populations previously supported by U.S. funding. These disruptions are resulting in staffing shortages, supply chain interruptions, and increased barriers to access, leaving key populations – including gay men and other men who have sex with men, sex workers, people who inject drugs, people in prisons, and trans and gender diverse individuals – vulnerable to infection and death, as well as increased stigma and discrimination.