Tailored HIV combination prevention services are accessible for key populations, including sex workers, men who have sex with men, people who inject drugs, transgender people and prisoners, as well as migrants

In 2020, key populations and their sexual partners accounted for 65% of new HIV infections worldwide and over 93% of new infections outside sub-Saharan Africa. Key populations continue to be marginalized and criminalized for their gender identities and expression, sexual orientation, livelihoods and behaviours. Where same-sex sexual relationships, sex work and drug use are criminalized, levels of HIV status knowledge and viral suppression among people living with HIV are significantly lower than in countries without criminalization. Conversely, laws that advance nondiscrimination, the existence of human rights institutions and responses to gender-based violence are associated with improved HIV outcomes.  

HIV prevention services for key populations are unevenly accessible or entirely absent in many regions. Prevention coverage remains low for gay men and other men who have sex with men, including in some high-income countries; for sex workers in eastern and southern Africa and eastern Europe and central Asia; and for transgender people in all but a few countries. Harm reduction services for people who inject drugs are rarely provided on a meaningful scale. People in prisons and other closed settings are often not provided HIV services, despite the relative ease of doing so. 

COVID-19 further reduced the limited access of key populations to HIV and TB services. Community organizations have also noted that key populations have less access to social protection, including programmes to mitigate the impact of COVID-19.

Thus, in 2021 the Joint Programme supported more than 130 countries to overcome barriers in access to prevention and treatment services due to COVID-19––including reforms in service delivery, multimonth dispensing of ART and opioid agonist therapy––and leveraged communities’ knowledge and their organizations as effective outreach and service providers.The Joint Programme developed and disseminated tools and guidance to facilitate access to services for key populations and to improve countries’ capacities to improve strategic information on key populations and supported countries to reduce legal and policy barriers, enhance key populations’ access to services and combat stigma and discrimination.

Find more details in the SRA report.

Outputs 2016-2021

4.1Evidence-based HIV services for key populations implemented
4.2Comprehensive packages of harm reduction services established for people who inject drugs



Targets and Milestones 2021 Progress
Percentage of countries with comprehensive packages of services for key populations defined and included in national strategies (Men who have sex with men, Sex workers)

2021: 90%

2019: 80%

2017: 70%

74% [64/87]

Percentage of countries with comprehensive packages of services for key populations defined and included in national strategies (Prisons and closed settings)

2021: 50%

2019: 35%

2017: 20%

57% [50/87]

Percentage of countries implementing in combination the most essential interventions to reduce new HIV infections among people who inject drugs

2021: 60%

2019: 50%

2017: 30%

66% [27/41]

Data source: 2021 JPMS country reports data.