Prevention for Most-at-Risk Populations in PEPFAR Countries

Current HIV prevention efforts targeting most-at-risk populations (MARPS) reach a mere fraction of these individuals—injecting drug users (IDUs), men who have sex with men (MSM) and commercial sex workers (CSWs)—at greatest risk of contracting HIV. The February 18-20, 2009 technical consultation on Interventions with Most-at-Risk Populations in PEPFAR Countries was held in Chennai, India where local organizations have demonstrated their capacity to work effectively with MARPs. The meeting participants included US Government representatives who are currently implementing or planning to increase prevention activities for MARPS in the near future from Asia, Africa and the Caribbean, including experiences from concentrated, generalized and mixed epidemics.

The meeting centered on a discussion of the Core Components of a Strategic Response for MARPS, or those essential program dimensions that must be part of any effort to reach MARPS, including: measurement approaches, enabling environment, capacity building, a minimum package of prevention services, scaling-up the coverage, quality and intensity of prevention activities and monitoring and evaluation. Expert researchers explained the current status of MARPs activities, reviewing current experience and evidence pertaining to prevention activities designed specifically to reach IDUs, MSM and CSWs. Representatives of several HIV prevention programs addressing prevention for MARPS described their efforts, successes and challenges. Participants took part in site visits to local programs with demonstrated success in reaching MARPs. Finally, facilitated breakout sessions generated recommendations toward developing action plans.