Why Key and Priority Populations should be prioritized in the strategy to end HIV/AIDS

MARPs Network

MARPs Network

Although Uganda’s generalized HIV epidemic has a national prevalence of 6.3% among adults as of the UPHIA results 2016, the national HIV prevalence and incidence rates among key and priority are substantially higher than the general population rates.

The National HIV/AIDS Strategic Plan 2015/16 – 2019/20 has clearly identified and defined key and priority populations (KPs/PPs) in Uganda.[1] KP/PPs, also known as Most At-Risk populations (MARPs), refers to populations with a significantly high risk of contracting and transmitting HIV but have limited access to prevention, care, and treatment services. According to the National HIV and AIDS Strategic Plan (NSP), HIV prevalence among KP/PPs is at critical levels:

  • Fisher folk (22-29%)[2]
  • Long distance truck drivers (25%)[3]
  • Uniformed services personnel (18.2%)[4]
  • Sex workers (35-37%)[5]
  • Men who have sex with men (MSM) (13.7%)[6]

 

The National strategic Plan (NSP) and the expired National MARPS Action Plan 2015-17 noted the importance of KP-specific planning, specifically: ‘the importance of MARPS in the dynamics of the epidemic in the country and the need to mount an effective and sustainable response among these population groups.’[7]  As stated in the NSP, ‘there is an urgent need to invest in impactful combination prevention interventions to drastically reduce the number of new infections, in order to reach Zero new infections, Zero discrimination and Zero HIV and AIDS-related deaths.’[8] With KP/PPs’ high prevalence, higher levels of discrimination they face, and greater difficulties accessing care, KP/PPs must be considered as part of the impactful combination interventions needed to successfully achieve the goal of the NSP.

In June 2017, the Presidential Fast-Track Initiative emphasised Uganda’s effort to not only achieve the UNAIDS 90-90-90 targets, but to go further, and to end AIDS by 2030.

As such Uganda has already made national commitments to KP-programming. Further, having committed to the, Uganda must consider all populations in HIV programming.

References

  1. The National HIV Prevention Strategy for Uganda 2011-15, p. 11
  2. National HIV Strategic Plan p. 5, MoH & UAC 2014; Asiki et al. 2013
  3. National HIV Strategic Plan p. 5, MoH & UAC 2014
  4. National HIV Strategic Plan p. 5, MoH & UAC 2014
  5. National HIV and AIDS Strategic Plan 2015/2016 – 2019/2020 p. 5, Vandepitte et al. 2011; MoH & UAC 2014
  6. National HIV Strategic Plan p. 5, Crane Survey 2010
  7. The National MARPs Priority Action Plan 2015-2017, p. 7
  8. National HIV Strategic Plan p. 2

 

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“Stigma and discrimination still has terrible consequences. The very people who are meant to be protecting, supporting and healing people living with HIV often discriminate against the people who should be in their care, denying access to critical HIV services, resulting in more HIV infections and more deaths. It is the responsibility of the state to protect everyone. Human rights are universal—no one is excluded, not sex workers, gay men and other men who have sex with men, people who inject drugs, transgender people, prisoners or migrants. Bad laws that criminalize HIV transmission, sex work, personal drug use and sexual orientation or hinder access to services must go, and go now!”

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