People most at risk of HIV are failed by prevention services

A Ugandan lady wearing a green top and black hat © Peter Caton for Frontline AIDS

Kigali, December 5, 2019: Progress on HIV prevention is being undermined by countries’ failure to put people who are most at risk at the centre of their prevention strategies. New prevention shadow reports, released today by Frontline AIDS, show the scale of the prevention crisis affecting marginalised people.

The reports show that the needs of sex workers, men who have sex with men, transgender people and people who use drugs are frequently ignored, resulting in worryingly low levels of access to HIV prevention services across all seven countries featured in the reports.

In many of the countries, repressive laws and policies are fuelling the crisis as they lead to the criminalisation and exclusion of marginalised people. For example, all six of the African countries featured in the reports criminalise drug use and five of the six criminalise same-sex activity. As a result, people who use drugs and men who have sex with men are often unable to access the services they need to reduce their risk of HIV infection.

“Marginalised people are being hit hardest by the HIV prevention crisis,” said Christine Stegling, Executive Director of Frontline AIDS. “Our prevention reports show that, despite commitments by their governments, people are being denied access to HIV services simply because of who they are or how they earn a living. Unless these barriers are addressed urgently, marginalised people will continue to be on the frontline of the epidemic.”

The Prevention Shadow Reports complement the findings of the Global Prevention Coalition’s national-level reports. The reports were developed in partnership with civil society organisations in Kenya, Malawi, Mozambique, Nigeria, Ukraine, Uganda and Zimbabwe and they provide community-level insight into each country’s progress on HIV prevention.

Across the six African countries, the reports found that:

  • Service coverage for men who have sex with men was 25% in Nigeria, 4% in Mozambique and the remaining countries had no data.
  • Service coverage for people who use drugs was 34% in Kenya, 15% in Mozambique and Nigeria and 8% in Uganda. Malawi and Zimbabwe had no data.
  • No country exceeded Malawi’s 65% service coverage for sex workers.
  • With the exception of Kenya, no country published accurate size estimates for transgender people and, at present, none of the six countries are tracking or reporting on service coverage rates for transgender people.

“These reports show how slowly countries are moving to address the needs of marginalised people at risk of HIV,” said Matteo Cassolato, HIV prevention lead at Frontline AIDS. “Since we published our last prevention shadow reports in 2018, we have seen countries make positive commitments, but they must be backed by action to break down the legal, policy and structural barriers that marginalised people face when trying to access HIV services.”

Earlier this year, data released by UNAIDS showed that new HIV infections remain stubbornly high at an estimated 1.7 million and that, for the first time, people from key populations – including people who inject drugs, gay men and other men who have sex with men, transgender people, sex workers and prisoners – and their partners accounted for more than half of new infections globally.


Notes to Editors

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About Frontline AIDS

Frontline AIDS wants a future free from AIDS for everyone, everywhere. Around the world, millions of people are denied HIV prevention, testing, treatment and care simply because of who they are and where they live.

As a result, almost 2 million were infected with HIV in 2017 and almost 1 million died of AIDS-related illness.

Together with partners on the frontline, we work to break down the social, political and legal barriers that marginalised people face, and innovate to create a future free from AIDS.

Please visit our website to learn more.


HIV prevention