Consolidated Guidelines On Hiv Viral Hepatitis And Sti Prevention Diagnosis Treatment And Care For Key Populations

The Consolidated guidelines on HIV, viral hepatitis and STI prevention, diagnosis, treatment and care for key populations outline a public health response for five 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. Particularly for key populations, social, legal, structural and other contextual factors both increase vulnerability to HIV, viral hepatitis and STIs and obstruct access to health and other essential services. These guidelines highlight the critical importance of addressing structural barriers in all settings as a priority. In most countries, inadequate coverage and poor quality of services for key populations continue to undermine responses to HIV, viral hepatitis and STIs. All countries should prioritise reaching key populations and supporting key population communities to lead the response and provide equitable, accessible and acceptable services. In most countries, inadequate coverage and poor quality of services for key populations continue to undermine responses to HIV, viral hepatitis and STIs. All countries should prioritise reaching these key populations and supporting key population communities to lead the response and provide equitable, accessible and acceptable services to these groups.

In 2022, WHO published the Consolidated guidelines on HIV, viral hepatitis and STI prevention, diagnosis, treatment and care for key populations. These guidelines outline a public health response to HIV, viral hepatitis and sexually transmitted infections (STIs) for five key populations (men who have sex with men, sex workers, people in prisons and other closed settings, people who inject drugs and trans and gender diverse people). In this policy brief, we give an update on those parts of the guidelines which are relevant for sex workers.

In 2022, WHO published the Consolidated guidelines on HIV, viral hepatitis and STI prevention, diagnosis, treatment and care for key populations. These guidelines outline a public health response to HIV, viral hepatitis and sexually transmitted infections (STIs) for five key populations (men who have sex with men, sex workers, people in prisons and other closed settings, people who inject drugs and trans and gender diverse people). In this policy brief, we give an update on those parts of the guidelines which are relevant for men who have sex with men.

These consolidated guidelines on HIV prevention, testing, treatment, service delivery and monitoring bring together existing and new clinical and programmatic recommendations across different ages, populations and settings, bringing together all relevant WHO guidance on HIV produced since 2016. It serves as an update to the previous edition of the consolidated guidelines on HIV. These guidelines continue to be structured along the continuum of HIV care. Information on new combination prevention approaches, HIV testing, ARV regimens and treatment monitoring are included. There is a new chapter on advanced HIV disease that integrates updated guidance on the management of important HIV comorbidities, including cryptococcal disease, histoplasmosis and tuberculosis. The chapter on general HIV care, contains a new section on palliative care and pain management, and up to date information on treatment of several neglected tropical diseases, such as visceral leishmaniasis and Buruli ulcer. New recommendations for screening and treating of cervical pre-cancer lesions in women living with HIV are also addressed in this chapter. Guidance on service delivery was expanded to help the implementation and strengthening the HIV care cascade. Importantly, this guidance emphasizes the need for differentiated approaches to care for people who are established on ART, such as reduced frequency of clinic visits, use of multi-month drug dispensing and implementation of community ART distribution. The adoption of these efficiencies is essential to improve the quality of care of people receiving treatment and reduce the burden on health facilities, particularly in resource limited settings.