Nobody left behind

MISSION: Bringing greater attention to the challenges faced by key populations and supporting efforts to remove barriers affecting their access to HIV prevention, treatment and care services.

The substantial gains made in the global fight against HIV in recent years have not been shared equally across all groups. Key populations – including men who have sex with men (MSM), transgender individuals, sex workers, and people who inject drugs (PWID) – are at increased risk of HIV acquisition and experience higher rates of HIV prevalence compared with the general adult population. These men and women are routinely subjected to stigma, discrimination and violence, potentially increasing their risk of infection and obstructing their access to quality health services. They are frequently excluded from the decision-making processes that directly impact their lives, and rhetorical commitments made to increase services tailored to key populations’ needs are very often not backed up with adequate funding.


POLICY

HIV and the law

Regressive laws that criminalize HIV transmission or the identities and behaviours of key populations exist in one form or another in many countries. The criminalization of same-sex practices, sex work and drug use have presented a serious challenge to not only providing quality health services to these men and women, but protecting their human rights as well. In addition to actively challenging the criminalization of HIV and key populations, the IAS is working to inform global practice around the adoption of evidence-based and human rights-based policies to overcome the impact of such regressive legal environments.

Young key populations

Youth continue to be left behind in the AIDS response in much of the world, with young key populations facing even greater and more complex challenges. Barriers, such as the absence of age-appropriate service and the lack of educational and economic opportunities experienced by young people, are generally compounded by the stigma, discrimination and heightened risk of HIV acquisition that key populations routinely face. The IAS is working to draw attention to the unique challenges faced by young key populations by fostering youth leadership and creating opportunities to amplify youth voices to instigate change in national and global HIV policy affecting their communities.

Featured work:

Global expert consensus statement
The IAS is currently working with UNAIDS, the International Association of Providers of AIDS Care (IAPAC) and HIV Justice Worldwide to draft the Global Consensus Statement On The Science Of HIV In The Context Of The Criminal Law for use within the criminal justice system and to assist in law reform efforts.

More information coming soon.

HIV prevention realities
The Youth Champions programme recently awarded grants to eight Youth Champions teams in Kenya (HOYMAS), Swaziland (Family Life Association of Swaziland), South Africa (WITS RHI; Sexual and Reproductive Justice Coalition), Malawi (Malawi Liverpool Wellcome Trust Clinical Research Programme), Serbia (Association Prevent; Association Rainbow), Ukraine (Light of Hope) to highlight the specific HIV prevention needs of young key populations. As part of their grant projects, the Youth Champions are: i) conducting research on HIV prevention strategies for young sex workers; ii) organizing dialogue workshops for young sex workers, law enforcement officials and healthcare providers; and iii) implementing awareness campaigns around HIV combination prevention for young MSM.

More information coming soon.


RESEARCH

Understanding the science of HIV-related stigma and discrimination

Fear of stigma and discrimination within healthcare settings, perpetrated by health workers, is a primary barrier to key populations accessing health services. Despite the increasing volume of evidence demonstrating the link between stigma and discrimination and reduced uptake of health services, vital gaps remain in research into interventions that effectively reduce stigma and discrimination toward key populations within healthcare settings.

Featured work:

Promoting innovation
To identify and support the creation of evidence-based interventions to challenge and ultimately eliminate the impact of stigma in healthcare settings, the IAS has partnered with ViiV Positive Action to launch the “Combatting Stigma and Discrimination in Healthcare Settings” challenge, a grants initiative that will award up to £100,000 to a programme that effectively reduces stigma in a healthcare setting, leading to increased uptake of prevention and VCT services, as well as retention, among key population clients.

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Expanding the evidence base on HIV among transgender populations
In July 2016, the Journal of the International AIDS Society published the special issue entitled “HIV epidemics among transgender populations: the importance of a trans-inclusive response”. It focused on expanding the evidence base on HIV among transgender populations. The aim was to make the latest research widely accessible in order to better enable funders, policy makers and implementers around the world to develop HIV policies and programmes based on the most current trans-specific knowledge. This supplement was supported by the USAID LINKAGES project.

Read the supplement


STRUCTURAL BARRIERS

Reducing stigma in healthcare settings

Stigma and discrimination in healthcare settings continues to be a barrier to members of key populations accessing HIV prevention, treatment and care services. Fear of discrimination can dissuade potential clients from seeking care, and a lack of understanding of the specific and diverse health needs of key populations on the part of healthcare workers can lead to low-quality and ineffective care. The IAS is committed to instigating action to remove such structural barriers and address human rights violations.

Featured work:

Code of conduct for HIV professionals
In 2014, the Nobody Left Behind initiative recently established a Human Rights Code of Conduct for HIV Professionals to provide a human rights-based framework for accelerating access to high-quality services for key populations.

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Celebrating frontline healthcare provider for #DoingTheRightThing
Despite the persistent perpetration of stigma and discrimination toward key populations in healthcare settings, there are countless healthcare workers pushing to provide safe, high-quality, client-competent prevention, treatment and care services to these men and women, often in the face of discriminatory laws, traditions and belief systems. To recognize and celebrate these many doctors, nurses, receptionists, pharmacists and other frontline healthcare providers who are “doing the right thing”, the Me and My Healthcare Provider campaign was launched in 2016. Driven by representatives of key populations, Me and My Healthcare Provider creates an opportunity to acknowledge the contributions of healthcare providers who have made a tangible difference in their lives. The campaign is intended to highlight best practices and establish a community of good practice for key populations within clinics, as well as highlight the importance of the client-provider relationship as a key element in delivering HIV services.

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