Framework for Monitoring HIV/STI Services for Key Populations in Latin America and the Caribbean

Abstract

In Latin America and the Caribbean, between 50% and 65% of new HIV infections occur in key populations of the HIV epidemics and their sexual partners. Improving the availability and coverage of HIV/STI services for these populations requires the support of monitoring systems that are sustainable and adapt to the needs of the countries of the region. To respond to this need, the Pan American Health Organization, through an agreement with The Global Fund to Fight AIDS, Tuberculosis and Malaria, has developed the Framework for Monitoring HIV/STI Services for Key Populations in Latin America and the Caribbean. It introduces a novel system in which the impact of HIV services on key populations is determined, not only by how HIV-positive people maintain an undetectable viral load but also by how HIV-negative people remain HIV-free. This document lists the essential HIV/STI services that, based on a combination prevention approach, should be offered to people from key populations. The monitoring framework establishes one or more indicators for each of the essential services together with the methodology for their measure. Likewise, a new HIV “prevention cascade” is introduced, which adds to the existing HIV care cascade. Countries are encouraged to disaggregate by key population group (i.e. gay men and other men who have sex with men, female sex workers, and transgender women) the HIV prevention and care cascades as well as the indicators. Finally, it is important to show the contribution of civil society organizations in the HIV and STI response to ensure their sustainability as external funding to the region decreases. To this end, the framework encourages breaking down the prevention and care cascades information by the service provider, to identify the contribution of health ministries, civil society organizations, and other actors.