Key populations at risk: Number and percentage of key populations at risk reached with HIV prevention programs (HIV-P5)
This indicator aims to monitor coverage of prevention HIV programs through program data. It should be calculated and reported separately for each population group that is considered at risk depending on the country context.
Key populations, also known as most-at-risk populations (MARPs), are communities of subpopulations that are key to the dynamics of a country’s epidemic. These have HIV-prevalence rates that are higher than those in the general population. Key populations include: people who inject drugs, sex workers, men who have sex with men and transgender people. Other vulnerable populations that can be considered to be at risk are prisoners, young people out of school, mobile populations, military and uniformed services, etc. Key populations at risk are often difficult to reach with HIV prevention programmes. However, preventing the spread of HIV among these populations and among the general population requires that they access these services.
Number of key populations at risk who have received a basic (minimum) package of HIV prevention service.
Estimated number of the targeted key population at risk.
Numerator / Denominator
The data should be collected through program monitoring reports of implementing partners on a regular basis. These records are compiled and aggregated to obtain an overall measure of the number of people reached by a prevention program. Implementers at the community level need to devise reliable systems and tracking mechanisms that capture accurate data. When reporting on coverage the following should be considered:
1. Defined basic (minimum) package of HIV prevention service. This is the minimum number of services that an individual should receive to be counted as “reached” and by no means diminishes the importance of other relevant services provided at service delivery points. The basic (minimum) package of services needs to be defined on national and/or service delivery level. For example, the basic (minimum) package of services for key populations could include: behaviour change communication (promoting safer behaviour and educational materials); provision of consumables (condoms; lubricants, needles and syringes as needed); counselling from a social worker or other relevant specialist; and referral to another specialist or service, as appropriate and based on individual client needs.
2. System to avoid double counting. There is a need to ensure that number of individual “clients served” at the same service or across services are counted as opposed to number of “client visits”. This can be ensured through implementation of Unique Identification Codes (UIC) and use of databases for data aggregation and reporting.
3. Population size estimates. Reporting on actual coverage (percentage) of key populations at risk will depend on availability of reliable and up-to-date population size estimates. In case size estimates are not available and/or reliable, only the numerator should be reported for this indicator.
Age group: (greater than) 25 years
This indicator provides information on the total number and percent of unduplicated individuals that received a basic (minimum) package of HIV prevention services. While each of the single interventions is useful in HIV prevention, it is important to recognize that when delivered as a package will have the greatest beneficial impact. The indicator will help to determine reach (if no denominator) and coverage (if denominator is also collected) to help country programs understand the extent and reach of evidence-based programs for further expansion.