The recently released Global Fund 2017–2021 strategy and U. S. President’s Emergency Plan for AIDS Relief (PEPFAR) 3.0 have highlighted the need for data that inform an effective HIV response, including data that define scale and program content to respond to evidence-based need. Defining this need specifically among key populations, which have a disproportionate HIV burden, has been particularly difficult in the context of generalized epidemics where less attention has historically been placed on these groups. There is a gap, then, in our understanding of the specific needs of—and ultimately the investment case for the added value of supporting—disproportionately burdened key populations in the context of generalized HIV epidemics.
Project SOAR is conducting a study that has two primary purposes: (1) synthesizing and assessing the quality of available data for key populations; and (2) utilizing the findings to strengthen capacity of a strategic group of governmental, non-governmental, and community stakeholders to effectively use these data to prioritize rights-based, comprehensive data collection efforts and programmatic responses. The first phase of this work involves systematically collecting all available data characterizing (1) the burden of HIV; (2) determinants of HIV infections including individual, network, and structural determinants of risk; (3) population size estimations for key populations (sex workers, gay men, and other men who have sex with men, transgender women, incarcerated populations, and people who use drugs); and (4) programmatic and intervention data for all high impact countries in sub-Saharan Africa, Eastern Europe, the Former Soviet Union, Central Asia, and Asia. The second phase will prioritize countries in line with US Government (USG) program priority investments and with the Global Fund to represent multiple regions and HIV epidemic settings. In these countries, SOAR will collaborate with USG programs and the Global Fund to strengthen the capacity of key stakeholders (government, community, and researchers) to understand the availability and quality of data from their country, as well as regionally, and to prioritize data needs to define evidence-based HIV responses for key populations. In partnership with this broad set of stakeholders, small area estimation analyses of epidemiologic data, including the estimation of denominators, will be presented and discussed to inform the development of Country Operational Plans (COPs).
The intended impact of this process is the increased uptake and use of high quality, comprehensive epidemiologic and interventional data in Global Fund and USG COP planning, while building consensus on small area estimations of available data to guide additional data collection and programmatic efforts focused on HIV among key populations in future funding proposals.