BACKGROUND: Global funding for HIV programming has decreased, and more funders are prioritizing “transition” or “sustainability” strategies. Continued HIV services for key population (KP) communities under alternative forms of financing require thoughtful consideration prior to transition and inclusion of KP perspectives to ensure continued service utilization and funding.
DESCRIPTION: The EpiC Project and Global Black Gay Men Connect (GBGMC) conducted five virtual focus group discussions between August-October 2023. Participants represented a diverse range of perspectives including 84 members of KP communities and organizations serving KP communities from 27 countries in Africa, Asia, and the Caribbean. Participants shared viewpoints in a pre-consultation survey (n=75), a two-hour discussion (n=84), and a post-consultation survey (n=37). One consultation was held in French, and four in English. Anonymized pre-consultation survey results were presented during focus groups. Focus groups were transcribed, excluding identifying details, and notes analyzed for prevalent themes.
LESSONS LEARNED: Consistently, participants highlighted the importance of meaningful involvement of KP communities, including engagement in design, delivery and evaluation of services paired with capacity strengthening support, to ensure communities are prepared to lead service delivery. Access to client-centered HIV services tailored to KP communities (preferably at KP-led facilities) free of stigma and discrimination was noted as critical. Adequate financing for services including access to innovative financing structures such as social contracting or social enterprise to meet needs not funded by governments or other donors was also a theme.
Regarding current services, participants said: "The involvement of key population groups in providing sustainable services is essential ... In [my country], the proportion of clients coming to key population-led facilities is 3-4 times higher than public facilities. And for the clients who come to public facilities … they usually go with a key population supporter."
In the post-consultation survey, participants requested in-person consultations to have a more nuanced exploration of local financing options, and review models of effective engagement and capacity strengthening for KP communities.
CONCLUSIONS: As sustainability related conversations with funders and governments move forward, further dialogue and engagement of key population communities is needed to ensure equitable access to services in the future and sustain current gains in service delivery.