Enhancing benefits or increasing harms: community responses for HIV among men who have sex with men, transgender women, female sex workers, and people who inject drugs.

Journal Article (Journal Article;Review;Systematic Review)

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.

Full Text

Duke Authors

Cited Authors

  • Baral, S; Holland, CE; Shannon, K; Logie, C; Semugoma, P; Sithole, B; Papworth, E; Drame, F; Beyrer, C

Published Date

  • August 15, 2014

Published In

Volume / Issue

  • 66 Suppl 3 /

Start / End Page

  • S319 - S328

PubMed ID

  • 25007203

Electronic International Standard Serial Number (EISSN)

  • 1944-7884

Digital Object Identifier (DOI)

  • 10.1097/QAI.0000000000000233


  • eng

Conference Location

  • United States