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About Our Work: Most-at-Risk Populations (Last Updated: January 2005) |
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More than 5 million people each year are
newly infected with HIV. Although many persons
have some level of risk for acquiring HIV, some
persons are especially vulnerable due to their
behavior or the behavior of their partners.
Most at risk populations vulnerable to HIV
infection include but are not limited to:
- injection drug users who share HIV
contaminated drug injection equipment;
- individuals who abuse other substances
such as non-injection drugs and alcohol;
- commercial sex workers and their sex
partners;
- youth and street children;
- persons detained in corrections
facilities; and
- men who have sex with men.
A comprehensive HIV prevention strategy must
include combinations of interventions for
populations most at risk for HIV infection. In
resource-constrained countries, the Global AIDS
Program (GAP) is encouraging a multi-component
targeted intervention approach, relying on
evidence-based interventions and supportive
policies to prevent the spread of HIV infection
and to provide comprehensive treatment for
persons who become HIV-infected. These
interventions include:
- outreach to populations most at risk for
HIV;
- voluntary HIV counseling and testing
adapted to specific populations;
- education to prevent transmission of HIV
through sex or needle sharing;
- treatment of sexually transmitted
infections (which can facilitate transmission
of
HIV infection);
- treatment of HIV/AIDS, including
counseling to prevent further spread to
partners.
In Vietnam, the Global AIDS Program (GAP),
with U.S. Government (USG) funding:
- collaborated with the Ministry of Health
to adapt the World Health Organization (WHO)
training guide for HIV prevention outreach to
injection drug users (IDUs);
- coordinated a symposium for public health
officials to review the evidence-based
findings and best practices on HIV prevention
for drug users to improve provincial program
planning and implementation;
- coordinated a rapid assessment on the HIV
care and treatment and drug treatment needs
for at risk populations.
In Kenya, GAP, with USG funding:
- collaborated with partners to conduct a
training course for a community-based outreach
program for vulnerable populations designed to
refer IDUs and commercial sex
workers to voluntary HIV counseling and
testing, drug treatment, and HIV treatment
Services.
In the Asia Region, GAP, with USG funding:
- planned and hosted a meeting on drug
treatment, HIV care and treatment activities
for IDUs. Cambodia, China, Lao PDR, Thailand,
and Vietnam participated and developed action
plans for future activities in their
countries.
Why does CDC work with populations
most-at-risk for HIV?
Entry of HIV infection into a country's
vulnerable populations can have major impact on
the course of the HIV epidemic. At the end of
2003 in Vietnam, there were 220,000 persons
living with HIV/AIDS. More than 50% of these
persons were injection drug users (IDUs).
However, the epidemic appears to be evolving
such that HIV infection is spreading from IDUs
and women who trade sex for money to their sex
partners, and other members of the general
population. For example, recent HIV prevalence
surveys in Vietnam show that rates of infection
among women receiving prenatal care are
increasing - signaling that the HIV epidemic in
Vietnam is moving into the general population.
International Rapid Assessment, Response
and Evaluation
The International Rapid Assessment, Response
and Evaluation, or I-RARE, project helps
communities identify strategies to enhance HIV
prevention, maximize community health services,
and provide access to care for populations most
at risk for HIV/AIDS.
Cambodia is facing emerging epidemics of drug
use and HIV. The Global AIDS Program in
Cambodia, in collaboration with the World Health
Organization (WHO) and Joint United Nations
Programme on HIV/AIDS (UNAIDS), conducted a
rapid assessment to better understand the
situation and to develop a plan to address the
growing HIV epidemic among drug users. The
assessment is guiding the development of
prevention, care and treatment programs for drug
users in Cambodia.
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