Framework for Monitoring HIV/STI Services for Key Populations in Latin America and the Caribbean

Abstract

In Latin America and the Caribbean, between 50% and 65% of new HIV infections occur in key populations or their clients or sexual partners. Improving the availability and coverage of HIV/STI services for these populations requires the support of monitoring systems that are sustainable and adapt to the needs of the countries of the region. To respond to this need, the Pan American Health Organization, through an agreement with the Global Fund, has developed the Framework for Monitoring HIV/STI Services for Key Populations in Latin America and the Caribbean. It introduces a novel system in which the impact of HIV services on key populations is determined, not only by how HIV-positive people maintain an undetectable viral load but also by how HIV-negative people remain HIV-free. This document lists the essential HIV/STI services that, based on a combination prevention approach, should be offered to people from key populations. The monitoring framework establishes one or more indicators for each of the essential services together with the methodology for their measure. Likewise, a new HIV prevention cascade is introduced, which adds to the existing HIV care cascade. Countries are encouraged to disaggregate by key population group the HIV prevention and care cascades as well as the indicators. Finally, it is urgent to show the contribution of civil society organizations to the response to HIV infection and STIs to ensure their sustainability once external donors leave the region. To this end, the framework encourages breaking down the prevention and care cascades information by the service provider, to identify the contribution of health ministries, civil society organizations, and other actors.