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Monday, March 4, 2024

New WHO guidelines on HIV, hepatitis, and STIs 

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By Windie Khyla Pultam

Some of the life-threatening diseases that the world has been grappling with are the same ones that health experts have been dealing with for decades now. Researchers, doctors, health professionals, and investors have been pouring their knowledge and resources to develop the most advanced and effective treatments. However, these are not enough. The public has to play a role as well. 

Everyone in the world must come together to prevent the spread of life-threatening and contagious diseases including the Human Immunodeficiency Virus (HIV) infection and Acquired Immunodeficiency Syndrome (AIDS), among many others.

The red ribbon symbolizes supportsymbolize support and solidarity for people living with HIV

Last July, the World Health Organization (WHO) published new consolidated guidelines on HIV, viral hepatitis, and Sexually Transmitted Infections (STI) prevention, diagnosis, treatment, and care for key populations at the AIDS 2022 Conference in Montreal, Canada.

Per WHO, there are five key populations that can use the guidelines as an outline for public health response to HIV, viral hepatitis, and STIs. These are 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.

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It has been established that these populations are the ones more vulnerable to diseases and, unfortunately, many of the people under these categories are obstructed from accessing health and other essential services, especially those who are from Third World countries. That is why the new guidelines highlight the critical importance of addressing the structural barriers in all settings.

WHO promotes evidence and a rights-based approach to addressing viruses and infections as the center of the response. In 2020, WHO commissioned the global key population network – including the International Network of People Who Use Drugs (INPUD), the Global Action for Trans Equality (GATE), the Network of Sex Worker Projects (NSWP, and the Global Action for Gay Men’s Health Rights (MPACT) – to conduct values and preferences research within their communities in relation to HIV, viral hepatitis, and STIs services. Their research has been used to inform the development of the new WHO Consolidated guidelines on HIV, viral hepatitis, and STI prevention, diagnosis, treatment, and care for key populations. 

“Key populations must be prioritized in every setting, and this means, as outlined in these new guidelines, planning to reach them first with the prevention, testing, and treatment as well as prioritizing key populations in funding programs,” says Erika Castellanos, director of programs at GATE (the Global Action for Trans Equality) and former co-chair of the WHO Guidelines Development Group.

It was reported that 70 percent of new HIV infections came from key populations and their partners. Services such as virtual or online interventions and peer navigators to help the members of the five populations with health services are some of the new recommendations highlighted in the guidelines.

In the consolidated guidelines by WHO, prioritizing key populations in every setting was highlighted — including reaching out to them first with the prevention, testing, and treatment as well as prioritizin

In addition, the new recommendations address chemsex, or using drugs to coincide with a person’s intimate life, more frequent testing of hepatitis C virus (HCV) for people at ongoing risk of infection, and provision of immediate HCV treatment for those who recently acquired the virus. It was noted in the guidelines that prioritized behavioral interventions aimed at changing behaviors have no impact on the incidence of HIV, viral hepatitis, and STIs or behavior change.

The new guidelines, which can be accessed and downloaded through the WHO website, is a 105-page file, divided into nine chapters. In it, the methods employed were discussed thoroughly. As well as the critical enablers of these new guidelines, also dissected were: the key population’s experience, values, and preferences related to structural barriers;  the essential interventions for impact, as well as legal and policy barriers. 

The guidelines also touched on the stigma and discrimination attached to these diseases, and how community empowerment can help address these concerns. A full chapter was also dedicated to the recommended package of interventions by key populations; service delivery; program and service considerations for young key population groups; and the developing response on the decision-making, planning, and monitoring process utilized for this entire project.  

You may check and download the file at https://www.who.int/publications/i/item/9789240053274. For more information about this, visit the WHO website.  

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