Hivos Southern Africa is currently managing a Global Fund to Fight AIDS, Tuberculosis and Malaria (GFATM) programme with a budget of US $11.4 million titled ‘Key Populations: Representation, Evidence and Attitude Change for Health Impact’ (KP REACH). It targets marginalised communities in Botswana, Lesotho, Malawi, Namibia, South Africa, Swaziland, Zambia and Zimbabwe, which according to the UNAIDS 2014 Gap Report, account for 81 per cent of people living with HIV in sub-Saharan Africa.
A consortium of KP networks and organisations that include African Men for Sexual Health and Rights (AMSHeR), African Sex Worker Alliance (ASWA), Coalition of African Lesbians (CAL), the Southern Africa Trans* Forum, Positive Vibes, SAfAIDS and M&C Saatchi World Services will be responsible for rolling out the programme in target countries while the Southern African AIDS Trust (SAT) is the secretariat for the Regional Oversight Committee (ROC).
The three-year Global Fund-supported programme was officially launched in Harare, Zimbabwe, on the sidelines of the International Conference on AIDS and STIs in Africa (ICASA) held from 29 November to 4 December.
Despite enormous achievements in the last decade in the provision of treatment and the reduction of AIDS-related deaths, which fell by 39 per cent between 2005 and 2013 in sub-Saharan Africa, new infections among key populations (KPs) are on the rise, specifically among young KPs, sex workers (SW), men who have sex with men (MSM) and transgender people (TG). Little information is available on people who inject drugs (PWID).
For women who have sex with women (WSW), there is a growing body of evidence to suggest that WSW in Southern Africa are at greater risk for HIV infection than was previously believed. This research points to increasing vulnerability to gender-based and sexual violence and hence greater exposure to HIV.
The overall goal of the programme is to strengthen regional KP networks and communities systems in Southern Africa. The aim is for these groups to advocate for policy change and change in the attitudes and beliefs aimed at reducing HIV incidence and mortality among KPs and to increase the sustainability of the HIV response.
An interrelated set of objectives has been formulated as part of the regional response, with anticipated impact and outcomes at national level. These include:
Strengthening four existing and/or emerging regional KP networks in Southern Africa so that they are able to work together and with others strategically and efficiently toward the effective development, monitoring and reporting of HIV prevention, testing and treatment programmes and policies at the regional and national level.
Improving data collection as well as the use, management, scaling up and replication of innovative best practices to enable more responsive programming and policies at the national level that will improve KP access to HIV prevention, testing and treatment.
Developing and disseminating messaging co-created with KPs to shift attitudes and beliefs and reduce the stigma and discrimination that are key barriers preventing KPs from accessing prevention, testing and treatment for HIV.