Bibliography on Syndemics of HIV, STIs, TB, Hepatitis, Mental Health and Psychosocial Issues and Substance Abuse Among Key Populations
Introduction: Many studies have shown that key populations, including men who have sex with men, female sex workers, persons who inject drugs and transgender men and women face stigma, violence and discrimination as well as suffer from high rates of mental health/psychosocial issues and substance abuse. However, services to address these issues for key populations remain under resourced.
Methods: We did a search of the literature to summarize the evidence base for comprehensive services addressing key populations’ varying needs. We divided the studies and reviews by geography into HAI focus countries, systematic reviews, West and Central Africa, Northern, Southern and Eastern Africa, other low and middle-income contexts, and high-income contexts.
Results: We located studies related to eight themes: 1. Syndemics (19 studies inc. 3 systematic reviews/meta-analyses); 2. High prevalence of trauma, mental health issues and substance abuse among key populations (64/8); 3. Trauma and how it increases HIV transmission risk (35/5); 4. Associations of trauma with mental health/psychosocial problems (34/5); 5. How trauma and its effects are important barriers to access to HIV services, adherence and viral load suppression (43/13); 6. Associations of mental health and cognitive problems with HIV infection itself (17/3); 7. Needs of female key populations for reproductive health and rights services (12/1); and 8. Results of programming models to address these issue, including improved adherence to ART and viral load (38/12). The studies in this bibliography are not comprehensive by any means and we will continue to update it periodically.
Conclusion: Strong evidence exists to suggest that reaching the UNAIDS 90/90/90 (90% of HIV-positives know their status, 90% of people with HIV are on antiretroviral therapy, and 90% of patients on antiviral therapy reach viral load suppression) among key populations will require programming to mitigate the impact of trauma.