WHO publishes new guidelines on HIV, hepatitis and STIs for key populations - Lack of impact of behavioural interventions

4 August, 2022

Extracts below and a comment from me. Read online: https://www.who.int/news/item/29-07-2022-who-publishes-new-guidelines-on...


The guidelines outline a public health response to HIV, viral hepatitis and sexually transmitted infections (STIs) for 5 key populations (men who have sex with men, trans and gender diverse people, sex workers, people who inject drugs and people in prisons and other closed settings)...

“The new data from UNAIDS show that around 70% of new HIV infections occur among key populations and their partners...” said Meg Doherty, Director of WHO’s Global HIV, Hepatitis and STI Programmes...

These guidelines also acknowledge that behavioural interventions aimed at changing behaviours – which tend to be prioritized in many settings – have no impact on incidence of HIV, viral hepatitis and STIs or on behaviour change.

A summary of the guidelines is provided in the policy brief.



COMMENT (NPW): The publication's categorical rejection of behavioural interventions is interesting. The full text of the guideline says little more on this: 'Counselling interventions which promote abstinence from drug use, rehabilitation or cessation of sex work or drug use, or a so-called cure for homosexuality or gender incongruence (for example, so-called conversion therapy)* are not recommended, and create barriers to key population service access.' [...] 'Counselling and information sharing, not aimed at changing behaviours, can be a key component of engagement with key populations, and when provided it should be in a non-judgemental manner, alongside other prevention interventions and with involvement of peers.'

These statements align with previous HIFA discussions, where some of us have argued that a focus on meeting information needs so that people can make their own informed decisions is critical, whereas a focus on changing behaviour is potentially disempowering and can be misplaced. Of course, these two approaches are often mixed and 'behavioural interventions' can be based primarily on providing reliable information.

I invite HIFA members to comment. hifa@hifaforums.org

Best wishes, Neil

Neil Pakenham-Walsh, Global Coordinator HIFA, www.hifa.org neil@hifa.org

Working in official relations with WHO