World Health Organisation release guidelines for HIV prevention and treatment
In the lead up to AIDS 2014, the World Health Organization (WHO) has released the 2014 Consolidated Guidelines on HIV Prevention, Diagnosis, Treatment and Care for Key Populations.
Health organisations say the guidelines come at a critical time in the HIV response, as HIV incidence in key populations such as men who have sex with men (MSM) continue to increase.
The WHO guidelines aim to: provide a comprehensive package of evidence-based HIV-related recommendations: to increase awareness of the needs of and issues related to HIV; improve access and uptake of services; and create a greater national and global commitment to adequate funding and services.
The Global Forum on MSM and HIV (MSMGF) applauded WHO’s emphasis on the importance of human rights and health equity.
“The guidelines stress access to HIV prevention, treatment, care, and support as fundamental to realising the universal right to health,” said MSMGF Executive Director Dr. George Ayala
MSMGF also commended WHO for highlighting risks and issues specific to key groups including for the first time, separate sections and recommendations for transgender people.
MSMGF was involved in the development of the guidelines, serving on the guidelines development group and steering group, as well as conducting a study commissioned by WHO on the values and preferences of MSM regarding use of antiretroviral therapy as prevention.
“Implementation of the recommendations contained in these guidelines must incorporate a deeper and more nuanced understanding of the drivers of HIV vulnerability, including the role of structural factors play in stopping key populations from seeking out and accessing health services, particularly the stigma among many health care providers toward members of key populations,” said Ayala.
“We are pleased that the new guidelines have responded to evidence on the health benefits of PrEP,” Ayala said. “However, the PrEP recommendations for MSM and transgender people are fraught with challenges that need urgent attention.
“The MSMGF’s values and preferences study indicated potential complications of PrEP roll out among MSM in settings where basic HIV services like condoms, lubricants, and HIV treatment are difficult to obtain, or where basic services not already guaranteed to those who need and want them. In addition, MSM worldwide are worried about potential side effects and costs, and targeted education campaigns are needed to clarify PrEP’s implications. The guidelines’ recommendation on PrEP must be tempered by the needs and concerns of MSM on the ground, especially in resource-limited settings.”
WHO Guidelines include:
Explicit language around the correct and consistent use of condoms with condom-compatible lubricants;
A new recommendation on offering pre-exposure prophylaxis (PrEP) for MSM as an additional HIV prevention option
Considerations for offering PEP to key populations in need.
WHO's new Consolidated Guidelines on HIV Prevention, Diagnosis, Treatment and Care for Key Populations is available on the WHO's website.