This article is more than 5 years old. Information may no longer be current.
New WHO HIV guidelines focus on vulnerable populations
Click Here to Manage Email Alerts
WHO has released new strategies and treatment guidelines aimed at reducing HIV infections in key populations, including men who have sex with men, people in prison, injection drug users, sex workers and transgender people.
The Consolidated guidelines on HIV prevention, diagnosis, treatment and care for key populations will be presented at the annual International AIDS Conference in Melbourne, Australia.
The guidelines outline steps to reduce HIV infections and increase access to care for the five vulnerable populations, as well as offer clinical recommendations. According to WHO, female sex workers are 14 times more likely to have HIV than other women, and MSM are 19 times more likely to have HIV compared with the general population. Both transgender women and injection drug users are at a 50-fold increased risk for infection.
For the first time, WHO is recommending pre-exposure prophylaxis (PrEP) in MSM as a preventive measure, alongside condom use. Recent findings suggest that the incidence of HIV in MSM could be reduced as much as 20% to 25% through PrEP, averting up to 1 million new infections in this population over the next decade.
“None of these people live in isolation,” Gottfried Hirnschall, MD, director of the HIV department at WHO, said in a press release. “Sex workers and their clients have husbands, wives and partners. Some inject drugs. Many have children. Failure to provide services to the people who are at greatest risk of HIV jeopardizes further progress against the global epidemic and threatens the health and wellbeing of individuals, their families and the broader community.”
Gottfried Hirnschall
The guidelines have been released in light of new statistics that reveal significant progress in the global fight against HIV. Thirteen million people were receiving ART by the end of 2013 — 11.7 million of whom live in low- or middle-income countries. An increase in access to care has led to a 20% reduction in HIV-related deaths from 2009 to 2012, according to WHO.
However, in order for its recommendations and strategies to be implemented, WHO is calling on countries to remove certain social and legal barriers. These include the criminalization of homosexuality, recently seen in Russia and Uganda. In addition, the key populations targeted by the guidelines are less likely to have access to care.
“Bold policies can deliver bold results,” said Rachel Baggaley, MD, of WHO’s HIV department and an author of the new guidelines. “Thailand was one of the first pioneers of programs to recognize the need to keep sex workers healthy and reduce new HIV infection. Malaysia, Spain and the United Republic of Tanzania have made major advances in providing opioid substitution therapy and needles and syringe programs for people who inject drugs. Data show that where a combination of effective HIV prevention and treatment services for people who inject drugs are available, HIV transmission among people who inject drugs is minimal.”
According to WHO, clinical recommendations in the guidelines include measures to better manage sexual, reproductive and mental health, as well as coinfections, including tuberculosis and hepatitis. WHO also recommends the use needle and syringe and opioid substitution programs and offers strategies for the treatment for overdoses.
For more information: