Health Access

Key populations are often marginalised from HIV and health services, usually due to stigma and discrimination and isolation caused by the illegality or perceived unacceptability of their behaviour. Outreach by NGOs that have the trust and confidence of these populations is a primary method used to overcome this marginalisation. In some countries, outreach tasks have become part of the government or mainstream health response to HIV but this remains unusual in developing and transitional countries. The result is a large gap between reach into key populations to increase demand for services and supply of HIV testing and health services.

APMG works with both NGOs and health services to address supply and demand elements of programs that impact on health access by key populations. Our aim is to create a true continuum of care through the spectrum of services provided by these sectors that address the many needs of key populations. We also work specifically at the interface of outreach programs, NGO services and government health systems to increase knowledge and understanding among staff on how to best meet the needs of an individual: we call this our Localities approach.

Within HIV, the exciting shift towards Treatment as Prevention (TasP) suggests that high levels of antiretroviral therapy coverage amongst people living with HIV who require treatment, can bring an epidemic under control and eliminate new HIV infections. APMG believes that the TasP approach will only be effective if a strong focus is maintained on HIV testing and follow up for those most at risk of HIV infection and if it is an adjunct to HIV prevention work, using the proven methods of peer education, condom and injecting equipment distribution, safer sex and safer injecting education and harm reduction interventions.

APMG’s capacity building work in HIV and health, with and for key populations, is embedded within sound management and programmatic approaches including innovative measurement. The Unique Identification Code (UIC) system that APMG has developed in several countries assists in tracking patterns of service usage and reach, and measuring coverage among key populations. The Treatment Cascade provides a new way of presenting data to monitor engagement of populations with services. We have also worked in Procurement and Supply Management to ensure that commodities purchased for HIV prevention and treatment among key populations are appropriate, easily tracked and available where and when they are needed.

Centre for Global Development (Bill and Melinda Gates Foundation)
National AIDS Secretariat, Mauritius (UNDP)
National AIDS Secretariat, Mauritius (UNDP)
Temple University (DFID)
Russian Harm Reduction Network/ESVERO (GF)
Cardno Emerging Markets
DFAT Australian Aid