TY - JOUR
T1 - Enhancing benefits or increasing harms
T2 - Community responses for HIV among men who have sex with men, transgender women, female sex workers, and people who inject drugs
AU - Baral, Stefan
AU - Holland, Claire E.
AU - Shannon, Kate
AU - Logie, Carmen
AU - Semugoma, Paul
AU - Sithole, Bhekie
AU - Papworth, Erin
AU - Drame, Fatou
AU - Beyrer, Chris
PY - 2014/8/15
Y1 - 2014/8/15
N2 - Studies completed over the past 15 years have consistently demonstrated the importance of community-level determinants in potentiating or mitigating risks for the acquisition and transmission of HIV. Structural determinants are especially important in mediating HIV risk among key populations, including men who have sex with men, people who inject drugs, sex workers of all genders, and transgender women. The objective of this systematic review was to synthesize the evidence characterizing the community-level determinants that potentiate or mitigate HIV-related outcomes for key populations. The results of the review suggest that although health communication programs represent community-level strategies that have demonstrated the effectiveness in increasing the uptake of HIV testing and decreasing the experienced stigma among people living with HIV, there are limited studies focused on key populations in low-and middle-income settings. Moreover, interpretation from the 22 studies that met inclusion and exclusion criteria reinforce the importance of the continued measurement of community-level determinants of HIV risks and of the innovation in tools to effectively address these risks as components of the next generation of the HIV response. Consequently, the next generation of effective HIV prevention science research must improve our understanding of the multiple levels of HIV risk factors, while programming for key populations must address each of these risk levels. Failure to do so will cost lives, harm communities, and undermine the gains of the HIV response.
AB - Studies completed over the past 15 years have consistently demonstrated the importance of community-level determinants in potentiating or mitigating risks for the acquisition and transmission of HIV. Structural determinants are especially important in mediating HIV risk among key populations, including men who have sex with men, people who inject drugs, sex workers of all genders, and transgender women. The objective of this systematic review was to synthesize the evidence characterizing the community-level determinants that potentiate or mitigate HIV-related outcomes for key populations. The results of the review suggest that although health communication programs represent community-level strategies that have demonstrated the effectiveness in increasing the uptake of HIV testing and decreasing the experienced stigma among people living with HIV, there are limited studies focused on key populations in low-and middle-income settings. Moreover, interpretation from the 22 studies that met inclusion and exclusion criteria reinforce the importance of the continued measurement of community-level determinants of HIV risks and of the innovation in tools to effectively address these risks as components of the next generation of the HIV response. Consequently, the next generation of effective HIV prevention science research must improve our understanding of the multiple levels of HIV risk factors, while programming for key populations must address each of these risk levels. Failure to do so will cost lives, harm communities, and undermine the gains of the HIV response.
KW - HIV
KW - drug use
KW - epidemiology
KW - men who have sex with men
KW - sex work
KW - transgender
UR - http://www.scopus.com/inward/record.url?scp=84904122251&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84904122251&partnerID=8YFLogxK
U2 - 10.1097/QAI.0000000000000233
DO - 10.1097/QAI.0000000000000233
M3 - Article
C2 - 25007203
AN - SCOPUS:84904122251
SN - 1525-4135
VL - 66
SP - S319-S328
JO - Journal of Acquired Immune Deficiency Syndromes and Human Retrovirology
JF - Journal of Acquired Immune Deficiency Syndromes and Human Retrovirology
IS - SUPPL.3
ER -