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Why MARPs Matter and What Matters for MARPs

Why MARPs Matter and What Matters for MARPs An Assessment of Policy toward Most-at-Risk Populations (MARPs) for HIV/AIDS in West Africa A. Dutta, M. Maiga, C. Fung, L. Kapesa ICASA Session MOPDC01. Action for West Africa Region II. AWARE II Region :

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Why MARPs Matter and What Matters for MARPs

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  1. Why MARPs Matter and What Matters for MARPs An Assessment of Policy toward Most-at-Risk Populations (MARPs) for HIV/AIDS in West Africa A. Dutta, M. Maiga, C. Fung, L. Kapesa ICASA Session MOPDC01

  2. Action for West Africa Region II • AWARE II Region: • 21 Countries in West Africa • AWARE II Key Priorities include: • Identify, involve, and respond to needs of most-at-risk populations (MARPs) for HIV/AIDS This presentation introduces a major report: Dutta, Modibo, et al. (2011)AWARE-2, Accra: Ghana

  3. Who are the MARPs in West Africa? • Most-at-risk • Risk of getting infected with HIV (if HIV-negative) • Risk of transmitting HIV (if HIV-positive) • Based on HIV prevalence rates and data on sources of HIV incidence • Key populations for HIV policy • Three key MARP groups of West African relevance : • Female Sex Workers (FSWs) • Clients of female sex workers (clients) • Includes truckers, migrants, men in uniform, students, etc. • Men who have Sex with Men (MSM) When present in AWARE II countries: • Injecting Drug Users (IDUs)

  4. Why MARPs Matter: Importance to HIV Policy

  5. What matters for MARPs: Policy change • Formal Policies and Policy Implementation for MARPs: Framework Analysis • Policy input: A specific area of HIV-related policy that has a bearing on MARPs • Laws and Regulations (Formal Policies), • Interventions (related to Policy Implementation) • Individual/Direct: 7 policy inputs • Individual/Indirect: 6 policy inputsStructural/Direct: 7 policy inputs • Structural/Indirect: 4 policy inputs • Data Collection and Analysis • Secondary data from 20 AWARE-II countries • Issue, Background, Data, & Conclusions analyzed for each policy input • Allocated HIV prevention resources for MARPs analyzed: • AWARE II region vs. other sub-Saharan countries (data: UNAIDS)

  6. Conclusions Is prevention in the region responsive to importance of MARPs? NO • Inappropriate and inadequate at individual and structural levels • Promising interventions : Small scale and not combined for synergy • Community approaches : Untried • Resources for MARPs: Proportionally inadequate • Need to tackle stigma & discrimination (S&D) Is treatment/care responsive to the needs of MARPs? NO MARP-friendly services that work within the constraints of S&D are • Lacking (or) • Adopt ‘verticalization’ and/or are at small scale • Targeted programs for FSW; few for MSM Do govts. recognize the importance of MARPs in HIV policy? MIXED • Punitive laws hamper interventionswith MARPs • Government policy often contradictory

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