Most-At-Risk Populations (MARPs)
In many countries, most-at-risk populations (MARPs), including sex workers, men who have sex with men, and injection drug-users, bear a disproportionate burden of the HIV epidemic. These populations are often marginalized in ways that make accessing care and treatment more difficult than for most others. MSH’s MARPs programming focuses on increasing access to HIV care and treatment services for vulnerable populations by decreasing barriers to such services and introducing innovative, effective approaches to HIV prevention among MARPs.
Prevention and Organizational Systems – AIDS Care and Treatment (ProACT) Project
The goal of ProACT is to build the capacity of Nigeria’s public, private, and community sectors for sustainable HIV & AIDS prevention, control, care, and treatment. To achieve these goals, MSH provides small grants to community-based organizations that help them improve HIV services and referrals for MARPs and people living with HIV & AIDS. Community-based organizations also use these grants to sensitize people about HIV and provide tailored outreach to people living with HIV and MARPs.
AIDS Support and Technical Assistance Resource Program, Sector Two (AIDSTAR-Two)
Through AIDSTAR-Two, MSH provides technical expertise that helps countries develop and implement sustainable MARPs prevention and care activities. In sub-Saharan Africa, AIDSTAR-Two supports organizational capacity development to enhance implementation of HIV & AIDS programs for MARPs at the community level. AIDSTAR-Two services in Central Asia include outreach to MARPs and support for needle exchange programs, methadone assisted therapy, and voluntary HIV counseling and testing. In Latin America, MSH works with nongovernmental and civil society organizations to respond to the HIV & AIDS epidemic, particularly among MARPs.
Guyana HIV/AIDS Reduction and Prevention (GHARP II) Project
In Guyana, MSH’s MARPs programming focused on risk reduction through prevention interventions, awareness activities, and improved access to health services. MSH also sensitized health providers about the unique needs of MARPs, which created a more enabling environment for these individual to access HIV testing, treatment, and care. The project team recruited and trained social workers to help sex workers assess their individual risks and develop personalized risk-reduction plans, and conducted regular counseling with sex workers and their clients to ensure better adherence to safe-sex practices. In addition to risk reduction interventions, GHARP II also provided sex workers with social and economic support that helped them develop new professional skills and enabled them to transition out of sex work.
Strengthening TB and AIDS Response–Eastern Region (STAR-E) Project
Through the STAR-E project, MSH supports improved access to quality HIV & AIDS and TB services in 12 districts of eastern Uganda. STAR-E is actively working with partners to design and deliver targeted outreach to MARPs, primarily sex workers, fishermen, and long distance truckers. The project’s strategies include moonlight outreaches and other tailored activities to promote voluntary testing and counseling and referrals to care.