How can the global health community better reach marginalized HIV-positive populations? A different approach to service delivery and care could help achieve epidemic control around the world.
Although the global health community is making great strides towards controlling the HIV/AIDS epidemic, marginalized populations are often left behind. Regions such as Eastern Europe, Central Asia, and North Africa and the Middle East, are less commonly discussed in the HIV/AIDS context, yet face growing epidemics. Members of key populations within those regions, including gay men and other men who have sex with men, intravenous drug users, people in prisons, sex workers, and transgender people receive even less attention. The global health community must take the successes and lessons learned from applying new models of HIV care and treatment in sub-Saharan Africa and Southeast Asia and apply them to hard-to-reach, stigmatized, and disproportionally-affected key populations in other regions of the world.
Delivering Differently: The Case for Differentiated HIV Service Delivery
HIV/AIDS care and treatment has made huge strides over the last three decades. Most recently, the international community has declared that a ‘one-size-fits-all’ approach to treating HIV/AIDS patients is no longer enough, and that we must adapt HIV/AIDS treatment to the needs of individual patients and “meet people where they are.” This patient-centered, rights-based approach has become known in the global health community as “differentiated service delivery.” Models of differentiated service delivery include the creation of adherence groups, where stable HIV-positive patients join together to manage their treatment, receive bundled antiretroviral medications to distribute within their group, and advocate for resources. Other models include allowing a stable patient to pick-up multiple months’ worth of medications during one clinic visit or receive medications at community centers instead of traveling to the clinic.