Table 1.

Summary of relevant WHO recommendations for linked services key populations [7]

HIV Prevention

Post-exposure prophylaxis (PEP) should be available to all eligible people from key populations on a voluntary basis after possible exposure to HIV.

All pregnant women from key populations should have the same access to services for prevention of mother-to-child transmission (PMTCT) and follow the same recommendations as women in other populations.

Harm reduction

All people from key populations with harmful alcohol or other substance use should have access to evidence-based interventions, including brief psychosocial interventions involving assessment, specific feedback and advice.

Prevention and management of co-infections and co-morbidities

Key populations should have the same access to hepatitis B and C prevention, screening and treatment services as other populations at risk of or living with HIV.

Routine screening and management of mental health disorders (depression and psychosocial stress) should be provided for people from key populations living with HIV to optimize health outcomes and improve their adherence to ART. Management can range from counselling for HIV and depression to appropriate medical therapies.

Sexual and reproductive health

Screening, diagnosis and treatment of sexually transmitted infections should be offered routinely as part of comprehensive HIV prevention and care for key populations.

People from key populations, including those living with HIV, should be able to experience full, pleasurable sex lives and have access to a range of reproductive options.

Abortion laws and services should protect the health and human rights of all women, including those from key populations.

It is important to offer cervical cancer screening to all women from key populations.

(Note: for adolescent populations, HPV vaccination is an additional recommendation for prevention of HPV-associated disease including anogenital cancers).

It is important that all women from key populations have the same support and access to services related to conception and pregnancy care, as women from other groups.

Critical enablers

Laws, policies and practices should be reviewed and, where necessary, revised by policymakers and government leaders, with meaningful engagement of stakeholders from key population groups, to allow and support the implementation and scale-up of health care services for key populations.

Countries should work towards implementing and enforcing anti-discrimination and protective laws, derived from human rights standards, to eliminate stigma, discrimination and violence against people from key populations.

Health services should be made available, accessible and acceptable to key populations, based on the principles of medical ethics, avoidance of stigma, non-discrimination and the right to health.

Programmes should work towards implementing a package of interventions to enhance community empowerment among key populations.

Violence against people from key populations should be prevented and addressed in partnership with key population-led organizations. All violence against people from key populations should be monitored and reported, and redressal mechanisms should be established to provide justice.