Table 2.
Key components of a comprehensive prevention package
| The WHO comprehensive package for prevention | |||
|---|---|---|---|
| Essential health sector interventions | IDU | Sex workers | MSM |
| 1. Comprehensive condom and lubrication programming | ✓ | ✓ | ✓ |
| 2. Harm reduction interventions for substance use | Needle and syringe programs and opioid substitution therapy | ||
| 3. Behavioural interventions | ✓ | ✓ | ✓ |
| 4. HIV testing and counselling | ✓ | ✓ | ✓ |
| 5. HIV treatment and care | ✓ | ✓ | ✓ |
| 6. Sexual and reproductive health interventions | ✓ | ✓ | ✓ |
| 7. Prevention and management of co-infections and other co-morbidities | Viral hepatitis, tuberculosis and mental health conditions | Mental health; substance use | Mental health; substance use |
| Essential strategies for an enabling environment | Examples | ||
| 1. Supportive legislation, policy and financial commitment | Decriminalization of NSP and OST programs | Social Protection; Decriminalization | |
| 2. Addressing stigma and discrimination | ✓ | ✓ | ✓ |
| 3. Community empowerment | ✓ | ||
| 4. Addressing violence against people from key populations | ✓ | ✓ | ✓ |
| PrEP plus adherence support | ✓a | ✓a | ✓ |
a
Note that the WHO has currently only issued a strong recommendation for PrEP use among MSM. The WHO has made no recommendations regarding PrEP among PWIDs and sex workers but has called for PrEP demonstration projects to assess how to implement PrEP as part of comprehensive risk reduction services in these populations.
OST, opioid substitution therapy; NSP, needle and syringe exchange programs.