PD04.05
Background: Sero-discordant couples and Key Populations(KP) - including, but not limited to, men who have sex with men (MSM), sex workers (SWs) and people who inject drugs (PWID) - urgently need new, effective HIV prevention methods. Numerous studies have shown that pre-exposure prophylaxis (PrEP) and treatment as prevention (TasP) offer effective HIV prevention to these vulnerable groups. Prior to the 2013 South African AIDS Conference, a pre-conference satellite was conducted to gain key stakeholders' perspectives on the implementation of demonstrations projects for KP.
Methods: After a plenary session that reviewed current HIV prevention research and advocacy, 50 delegates were divided into four groups to debate opportunities and challenges for demonstration projects. The two key questions were: 1) Which HIV prevention research methods should be prioritized for demonstration projects among KP in SA; and 2) What will the main challenges be? The session was divided into four 15-minute focus groups, where the delegates circulated through topics. Facilitators captured key findings.
Results: There was strong agreement that PrEP and TasP should be available to MSM, SW, and PWID in SA. In order to achieve this goal, demonstration and pilot projects would be a valuable source of data on the implementation of ARV based prevention outside the clinical trial setting. The key recommendations focused on the need to implement demonstration projects that are tailored to priorities, needs and circumstances of diverse KP groups. Such projects should answer questions on adherence, the impact of stigma in health care settings, and access to care despite structural barriers such as criminalization of some KP.
Conclusions: Stakeholders who participated in the session highlighted need for PrEP access among KP in SA (and other African countries) in order to begin addressing effectiveness, acceptability, adherence and behavioral issues. Research, policy, and advocacy agendas, should consider these in the future.
