Key Populations in Africa demand bold actions on HIV/AIDs prevention.

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We are Africa’s key populations: gay and bisexual men and other men who have sex with men; trans and nonbinary people; sex workers of all sexual orientations, gender identities, and expressions; and people who use and inject drugs. And, we stand in solidarity with Africa’s lesbian, bisexual and queer women and intersex people excluded from targeted HIV prevention and treatment interventions. We convened on the sidelines of the 22nd ICASA, in-person in Durban, and virtually, and we reflected and agreed thus:

Our national governments; PEPFAR; the Global Fund to Fight AIDS, Tuberculosis and Malaria; the UN family; and private and public foundations are failing us: criminalized, marginalized and excluded populations. And not only us—but our sex partners, our children, our communities too. The off-track AIDS response reveals this. And we are demanding nothing less than a revolution in the response to the epidemic in our communities.

62% of new infections are among key populations and their sex partners. Gay men and other men who have sex with men, sex workers and people who use drugs face a 25–35 times greater risk of acquiring HIV, while trans women face a 49 times higher risk. Data from Zimbabwe suggest a 38% prevalence in trans men sex workers. HIV in trans men remains understudied, leading to the assumption that they bear little virus burden.

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