Key Populations
Key populations in the health response are populations that are often subject to discrimination, criminalization and human rights abuses, thereby severely limiting their ability to access health services. In some settings and populations, such as in prisons and among some migrant and displaced populations, risks of HIV, TB, malaria and other diseases are also high, while access to services is frequently poor. There is now strong recognition that major epidemics cannot be ended without greater attention to key populations in all epidemic settings. This includes addressing social, legal and cultural barriers to accessing HIV and other health services, and consistent inclusion and participation by key populations in policy development, health governance and programming.
HIV: Key populations include men who have sex with men, sex workers, people who inject drugs, transgender people, people in prisons and other closed settings, and their partners. People living with HIV are also part of the key populations. In 2023 1, median HIV prevalence among the adult population (ages 15–49) was 0.8% globally. However, because of marginalization, discrimination and in some cases criminalization, median prevalence was higher among certain groups of people.
- 2.3% higher among young women and girls aged between 15 and 24 in eastern and southern Africa
- 7.7% higher among gay men and other men who have sex with men
- 3% higher among sex workers
- 5% higher among people who inject drugs
- 9.2% higher among transgender people
- 1.3% higher among people in prisons.
- The risk of acquiring HIV is:
- 35 times higher among people who inject drugs than adults who do not inject drugs.
- 30 times higher for female sex workers than adult women of the general population.
- 28 times higher among gay and bisexual men and other men who have sex with men than adult men of the general population.
- 14 times higher for transgender women than adult cisgender women of the general population.
TB: Key populations may include people in prison and people in other closed settings, people living with HIV, migrants, refugees and indigenous populations.
Malaria: While the concept of key populations in the malaria response is relatively new, and less understood than for HIV or TB, refugees, migrants, internally displaced people and indigenous populations are all at greater risk of malaria transmission, as they have decreased access to care and are often marginalized.
The Global Fund’s technical Brief HIV Programming at Scale for and with Key Populations describes the essential interventions and approaches for key populations that should be incorporated in HIV funding requests. It is based on the latest normative and implementation guidance, including the World Health Organization (WHO) Consolidated Guidelines on HIV, Viral Hepatitis and STI Prevention, Diagnosis, Treatment and Care for Key Populations (2022) and other guidance documents.
When preparing funding requests and interventions to meet the needs of key populations, Country Offices are strongly encouraged to review the technical brief guidance in detail. This Introduction outlines why key populations are especially vulnerable to HIV. Section 2 examines the HIV Program Essentials and the prioritized interventions in the HIV Information Note, provides details relevant to key populations, and considers service delivery approaches. Section 3 shows how to incorporate key population interventions into Global Fund proposals. It is structured around three of the Global Fund Strategy’s objectives: 1) maximizing people-centred integrated systems for health, 2) maximizing the engagement and leadership of most-affected communities (including key populations), and 3) maximizing health equity, gender equality and human rights.
Key messages from the technical brief:
- Global HIV & AIDS statistics — Fact sheet | UNAIDS ↩︎
Resources
Functional Area: Human Rights Key Populations and Gender Project Stage: Grant Making and Signing Author: Other Language: English Type: Tool Topic: Key Populations, Key Populations, Gender, Grant Agreement Resource File Format: Link Resource Accessibility: Publicly accessible
Functional Area: Human Rights Key Populations and Gender Project Stage: Grant Making and Signing Author: The Global Fund Language: English Type: Policies, Procedures and guidance Topic: Key Populations, Human Rights and the law, Policy Framework, Policy Framework Resource File Format: PDF Resource Accessibility: Publicly accessible
Functional Area: Human Rights Key Populations and Gender Project Stage: Grant Implementation Author: The Global Fund Language: English Type: Policies, Procedures and guidance Topic: Key Populations, Gender, Policy Framework, Human Rights and the law Resource File Format: PDF Resource Accessibility: Publicly accessible
Functional Area: Human Rights Key Populations and Gender Project Stage: Grant Implementation Author: The Global Fund Language: English Type: Policies, Procedures and guidance Topic: Key Populations, Technical support and guidance, Policy Framework, Gender Resource File Format: PDF Resource Accessibility: Publicly accessible
Functional Area: Human Rights Key Populations and Gender Project Stage: Grant Making and Signing Author: UNAIDS Language: English Type: Report Topic: Human Rights and the law, Global HIV & AIDS Stats, Key Populations, Gender Resource File Format: Link Resource Accessibility: Publicly accessible
Functional Area: Human Rights Key Populations and Gender Project Stage: Grant Implementation Author: UNDP Language: English Type: Policies, Procedures and guidance Topic: Key Populations, HIV/AIDS , Health, Human Rights and the law Resource File Format: Link Resource Accessibility: Publicly accessible
Functional Area: Human Rights Key Populations and Gender Project Stage: Grant Making and Signing Author: UNDP Language: English Type: Tool Topic: Policy Framework, Human Rights and the law, Technical support and guidance, Key Populations Resource File Format: Link Resource Accessibility: Publicly accessible
Functional Area: Human Rights Key Populations and Gender Project Stage: Grant Making and Signing Author: UNDP Language: English Type: Policies, Procedures and guidance Topic: Key Populations, Gender, Communities and local development, Human Rights and the law Resource File Format: Link Resource Accessibility: Publicly accessible
Functional Area: Human Rights Key Populations and Gender Project Stage: Grant Implementation Author: UNDP Language: English Type: Policies, Procedures and guidance Topic: Key Populations, Human Rights and the law, Gender, Technical support and guidance Resource File Format: Link Resource Accessibility: Publicly accessible
Implementing comprehensive HIV-STI programmes with sex workers - practical approaches from collaborative interventions
Functional Area: Human Rights Key Populations and Gender Project Stage: Grant Implementation Author: WHO Language: English Type: Report Topic: Technical support and guidance, Key Populations, Human Rights and the law, Policy framework Resource File Format: Link Resource Accessibility: Publicly accessible
Functional Area: Human Rights Key Populations and Gender Project Stage: Grant Implementation Author: UNDP Language: English Type: Report Topic: Key Populations, Human Rights and the law, Human Rights and Drug Policy, Policy Framework Resource File Format: Link Resource Accessibility: Publicly accessible
Functional Area: Human Rights Key Populations and Gender Project Stage: Grant Making and Signing Author: UNDP Language: English Type: Tool Topic: Key Populations, Governance ; Rule of Law, HIV/AIDS, Policy Framework Resource File Format: Link Resource Accessibility: Publicly accessible
Functional Area: Human Rights Key Populations and Gender Project Stage: Grant Making and Signing Author: UNDP Language: English Type: Tool Topic: Key Populations, HIV/AIDS, Rule of Law, Governance Resource File Format: Link Resource Accessibility: Publicly accessible
Functional Area: Human Rights Key Populations and Gender Project Stage: Grant Making and Signing Author: UNDP Language: English Type: Tool Topic: Human Rights and the law, Civic engagement, Key Populations, HIV/AIDS Resource File Format: Link Resource Accessibility: Publicly accessible
Functional Area: Human Rights Key Populations and Gender Project Stage: Grant Making and Signing Author: UNDP Language: English Type: Tool Topic: Key Populations, Civic Society, HIV/AIDS, Human Rights and the law Resource File Format: Link Resource Accessibility: Publicly accessible
Functional Area: Human Rights Key Populations and Gender Project Stage: Grant Implementation Author: UNAIDS Language: English Type: Tool Topic: Technical support and guidance, UN Joint Programme, Human Rights and the law, Key Populations Resource File Format: Link Resource Accessibility: Publicly accessible
Functional Area: Human Rights Key Populations and Gender Project Stage: Grant Making and Signing Author: UNDP Language: English Type: Training and Workshop materials Topic: Key Populations, HIV/AIDS, Civil Society, Human Rights and the law Resource File Format: Link Resource Accessibility: Publicly accessible
Technical Brief - HIV Prevention, Testing, Treatment, Care and Support in Prisons and Other Closed Settings - A Comprehensive Package of Interventions Download
Functional Area: Human Rights Key Populations and Gender Project Stage: Grant Implementation Author: UNODC, UNDP, WHO, ILO, UNFPA, UNAIDS Language: English Type: Tool Topic: Key Populations, Health, HIV Prevention, Human Rights and the law Resource File Format: PDF Resource Accessibility: Publicly accessible
Functional Area: Human Rights Key Populations and Gender Project Stage: Grant Implementation Author: UNAIDS, UNDP, UNFPA, UNODC, WHO, Penal Reform international Language: English Type: Tool Topic: Key Populations, Policy Framework, Human Rights and the law Resource File Format: Link Resource Accessibility: Publicly accessible
Functional Area: Human Rights Key Populations and Gender Project Stage: Grant Implementation Author: UNDP Language: English Type: Report Topic: Key Populations, HIV, Access to Justice, Policy Framework Resource File Format: Link Resource Accessibility: Publicly accessible