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 These people are most at risk of becoming infected with the human
immunodeficiency virus that causes AIDS, yet are least likely to get
HIV prevention, testing and treatment services, the Geneva-based
United Nations health agency said.
"Globally we are failing certain populations that have the greatest
risk yet we know have universally poorer access to health services.
These are men who have sex with men, sex workers, transgender
persons, specifically transgender women, persons who inject drugs
and persons who are in prisons or other closed settings," Gottfried
Hirnschall, director of the WHO's department, told reporters at a
briefing.
"We are seeing exploding epidemics in some of these key
populations," he said, adding that these groups account for up to 50
percent of new cases of HIV infection.
The WHO said studies estimate that female sex workers are 14 times
more likely to have HIV than other women, gay men are 19 times more
likely to have HIV than the general population, and transgender
women are almost 50 times more likely than other adults to have HIV.
For injecting drug users, the risks of HIV infection can be 50 times
higher than the general population.
For the first time, the WHO said it "strongly recommends" that men
who have sex with men should consider taking antiretroviral AIDS
drugs as an extra way of protecting themselves against HIV
infection, alongside using condoms.
Such an approach, known as pre-exposure prophylaxis or PrEP, is a
way for people who do not have HIV but are at risk of getting it to
protect themselves by taking a single pill, usually a combination of
two antiretrovirals, every day.
PrEP, when taken consistently, has been shown to cut the risk of HIV
infection in high risk people by up to 92 percent.
"The reason that we are adding this to our prevention choices for
men who have sex with men is that we have these very worrying
increases in HIV incidence," said Rachel Baggaley, coordinator of
the WHO's department for HIV/AIDS.
AIDS experts estimate that globally, HIV incidence among gay men
could cut by 20 to 25 percent through PrEP, averting up to 1 million
new infections in this group over 10 years.
PROGRESS
Some 35.3 million people worldwide are infected with HIV, but the
rising number of patients reflects great strides in recent years in
developing sophisticated HIV tests and combination AIDS drugs and
getting them to many of those who need them to stay alive.
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As a result, the annual AIDS death toll is falling, dropping to 1.6
million people in 2012 from a peak of 2.3 million in 2005. New HIV
infections are also steadily declining, by one-third in 2013 from
2011.
This progress has raised hopes for a world free of AIDS or HIV in
our lifetime.
Yet figures show the key high risk populations continue to have high
infection rates, and appear to be hard to reach in terms of getting
the right prevention messages, or getting them the testing and
treatment health services they need.
Hirnschall said that in many countries, gay men, sex workers and
other marginalized groups are left out of national HIV plans and
excluded by discriminatory laws and policies.
"None of these people live in isolation," he warned. "Sex workers
and their clients have husbands, wives and partners. Some inject
drugs. Many have children. Failure to provide services to the people
who are at greatest risk of HIV jeopardizes further progress against
the global epidemic."
The WHO report, released ahead of the International AIDS Conference
in Melbourne, Australia, which begins on 20 July, said that by the
end of 2013, around 13 million people worldwide were taking AIDS
drug treatment. This has led to a 20 percent drop in HIV-related
deaths between 2009 and 2012, it said.
(Writing by Kate Kelland; Editing by Richard Chang)
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