Rapid analysis of HIV epidemiological and response data on vulnerable populations in the Great Lakes region of Africa

Abstract

The Great Lakes Initiative on HIV/AIDS (GLIA) was created in 1998 by the Governments of Burundi, Democratic Republic of Congo (DRC), Kenya, Rwanda, Tanzania and Uganda to address the HIV epidemic more effectively within the great lakes region, a region significantly affected by mobility, conflict and displacement. In developing a new 5-year HIV strategic plan, the GLIA undertook this analysis to decide: On which populations should the GLIA focus, why, and with what type of HIV interventions? Epidemiological data for the great lakes region suggest that higher risk populations are important in driving the epidemic, and that unprotected higher risk sex and paid sex remain key contributors. Long-distance truck drivers, fishermen & fisherwomen, uniformed services, refugees, internally displaced persons, prisoners, and females affected by sexual violence are populations of significant size (14 million persons), with HIV prevalence significantly higher than other sub-populations, and constitute a significant proportion of total People Living with HIV (PLHIVs) in the six countries (from 8 percent in Kenya to 20 percent in Uganda). They are not comprehensively targeted or well covered by national programs, but there is some evidence of success through promising interventions for these vulnerable populations. The 8 populations are important intervention targets because of their size, intensity of higher-risk sexual behaviors, level and trends of HIV prevalence, potential to act as an HIV bridging population into the general population, mobility or interaction with mobile persons, and exposure to conflict and violence. The study recommends: (a) evidence-informed interventions for each population; (b) strategic objectives for GLIA to consider; (c) four value-adding roles for GLIA - communications and advocacy; monitoring, evaluation and research; technical support; and networking.