At an aggregate level, global HIV incidence has shown a decline over the last decade. Whilst this achievement is important, granular analysis of epidemics across the world have shown an increase in risk and burden amongst some population groups, which are known as key populations. These key populations are at a high risk of HIV acquisition and transmission and represent a major share of the global HIV epidemic and influence the epidemic dynamics and play a role in determining the nature and effectiveness of the response.
The World Health Organisation (WHO) defines key populations as groups, who due to specific high risk behaviours, are at increased risk of HIV infection, irrespective of the epidemic type or local context. This disproportionate burden is a result of specific behaviours common to them and structural barriers that prevent their link to HIV prevention and care services. Inadequate coverage and poor quality of service for key populations further undermine the response to HIV, making HIV programming a key public health and equity consideration in these groups.
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