Key affected populations

The new Consolidated guidelines on HIV, viral hepatitis and STI prevention, diagnosis, treatment and care for key populations outline a public health response for 5 key populations (men who have sex with men, trans and gender diverse people, sex workers, people who inject drugs and people in prisons and other closed settings). They present and discuss new recommendations and consolidate a range of recommendations and guidance from current WHO guidelines.

Young transgender people’s immediate HIV risk is related primarily to sexual behaviours, especially unprotected anal sex with an HIV positive partner, but structural factors in addition to those already noted make young transgender people especially vulnerable to HIV. Stigma and discrimination against transgender people frequently cause them to be rejected by their families and denied healthcare services, including access to HIV testing, counselling and treatment.

It has long been acknowledged that sex workers – female, male and transgender – are at high risk of HIV exposure, especially in low- and middle-income countries. This is due in part to a high number of sexual partners and working environment which is not conducive to sex workers’ being able to protect their health and the health of their clients, including widespread criminalisation of sex work, violence perpetrated by both state and non-state actors and extreme levels of stigma and discrimination.

This brief offers a concise account of current knowledge respond to the overlapping vulnerabilities of young people concerning the HIV risk and vulnerability of young people who inject drugs or the specific legal challenges and ethical who inject drugs; the barriers and constraints they face concerns in working with children. These vulnerabilities to appropriate services; examples of programmes that require responses that may go beyond the harm-reduction programmes recognized as effective for adults.

This technical brief is one in a series addressing four young key populations. It is intended for policy-makers, donors, service-planners, service-providers and community-led organizations. This brief aims to catalyse and inform discussions about: how best to provide health services, examples of programmes that may work well in addressing their needs and rights, and approaches and considerations for providing services, programmes and support for young men who have sex with men (MSM).

The impact of drugs upon the lives of children and adolescents is an issue that has been largely overlooked to date in much of the debate and documentation on drugs. The purpose of this paper is to identify lessons learned, together with key implications for policy and programmes, arising from UNICEF’s experience to date of addressing children, drugs and HIV. The paper also suggests practical steps that could enhance the impact of UNICEF’s work in this area, within the overall frameworks of the Convention on the Rights of the Child and the UNICEF Strategic Plan 2014-17.