Who are key populations?

One may be tempted to confuse between vulnerable populations and key populations when talking about HIV/AIDS or any other epidemic. But these are two completely different notions.

When talking about vulnerable populations, we refer to groups of people who are particularly vulnerable to HIV/AIDS in certain situations or contexts, such as adolescents (particularly adolescent girls in Sub-Saharan Africa), orphans, street children, people with disabilities, migrants and mobile workers. These people are not affected by HIV uniformly across all countries and epidemics. Meanwhile key populations are defined by the World Health Organization (WHO) as people in the population who are at increased HIV risk in all countries and regions. In order words they are people who, due to specific higher-risk behaviors, are at increased risk of contracting HIV irrespective of the epidemic type or local context.

Key populations are identified by the UNAIDS (United Nations Programme on HIV and AIDS) in 5 groups which are:

• Men who have sex with men;
• People who inject drugs;
• Sex workers and their clients;
• Transgender people;
• People in prisons and other closed settings: they are also included in these guidelines because of the often high levels of incarceration of other groups, and of increased risk behaviors and lack of HIV services in those settings.

Key populations are essential partners to the dynamics of HIV transmission. Around the world, they face much higher rates of HIV and AIDS than the general population, and are the most contracting HIV. In 2019, statistics of the WHO revealed that over 60% of all new HIV infections globally are accounted for by key populations groups and their partners. This is due to the fact that those groups often have legal and social issues related to their behavior which increased their vulnerability to the virus.

This situation is mostly due to the fact that these groups are often difficult to reach for critical testing and treatment services. Globally, rates of the Key populations accessing safe, effective and quality HIV/AIDS services are extremely low, while stigma and discrimination including gender-based violence are high.

Key populations constitutes of the main target for the fight against HIV/AIDS worldwide, because they face significant barriers such as police harassment, societal discrimination, insufficient community-based capacity that prevents them from accessing the services they need. And with the Coronavirus crisis, those groups are more than ever exposed to the disease.