On February 8-10, 2011, PEPFAR conducted a technical consultation on HIV Prevention in Mixed Epidemics in Accra, Ghana to share best and promising practices for resource allocation and HIV prevention programming within mixed epidemics. A number of countries in sub-Saharan Africa have mixed HIV epidemics, where both most-at-risk populations (MARPs) and the general population appear to contribute significantly to transmission. While an international consensus definition of a “mixed epidemic” does not exist, these epidemics are generally considered to be low-level generalized epidemics (with prevalence ranging from 2-5%), with high rates of transmission among MARPs (with prevalence above 15%).
In these mixed epidemics, HIV prevention programs need to focus on addressing HIV transmission both among MARPs and the general population. To properly allocate PEPFAR resources among target populations, program managers need to understand the epidemiological data available and consider carefully how to prioritize between MARP-targeted programming and programming for the general population and youth. Seventy participants from 11 countries with mixed epidemics in sub-Saharan Africa (Nigeria, Ghana, Rwanda, Ethiopia, Burundi, Cote d’Ivoire, Cameroon, Burkina Faso, Djibouti, Kenya, Nigeria, Sudan and Uganda), members of the PEPFAR Technical Working Groups (TWGs) and participants from other multilateral or partner organizations were invited to this technical consultation.
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