The United States President's Emergency Plan for AIDS Relief

Minutes from February 1, 2011 MARPs Working Group Call

Office of the U.S. Global AIDS Coordinator

PEPFAR Scientific Advisory Board (SAB) Participants: Don DesJarlais, Mead Over, David Wilson, James McIntyre, Linda-Gail Bekker

Office of Global AIDS Coordinator (OGAC) Participants: Rich Needle, Rob Lyerla, Chau Nguyen


At the first call of the most-at-risk-populations (MARPs) working group of the PEPFAR Scientific Advisory Board, the background and purpose of the working group were discussed. This includes:

  • Bringing more attention around MARPs
  • Support and work with PEPFAR staff and leadership on MARPs issues
  • To help develop research agenda/portfolio in the area of MARPs
    • Provide feedback to PEPFAR in gaps and directions for evidence-based research
    • While research priorities were addressed by the Board at the inaugural SAB meeting in January, there is a need to further define the specific research areas needed for MARPs
    • Identify gaps in evidence base, with an eye towards programming, policy, practice and scale-up
  • Facilitate integration with other organizations (e.g. UNAIDS) in this area
  • Information sharing

Importance of focusing attention on these groups include beneficial spillover effects to the general population of treating MARPs and ensuring human rights to MARPs groups.

Definition of MARPs:

  • PEPFAR’s definition includes injecting drug users (IDUs), men who have sex with men (MSMs), and sex workers.
  • While it was discussed that adolescents and youth were also considered at-risk, it was decided among the group that the SAB should form a separate subgroup on youth as they are distinctly different from the above three MARPs (e.g. not behavior-based population; requiring school-based interventions, etc).

PEPFAR update:

Updates from PEPFAR discussed include:

  • Recently released IDU guidance
  • MSM guidance to be released (currently in clearance among USG staff)
  • FY11 PEPFAR RFAs to be released
  • NIH RFA to be released by NIDA targeting IDUs

Outstanding issues:

Outstanding issues discussed were:

  • Current coverage of ARTs available for MARPs
    • OGAC can share budget data on how much has been invested in MARPs
  • Strengthening behavioral surveillance for MARPs
  • No specific PEPFAR guidance documents have been developed for sex workers

Next steps:

  • Once the MSM guidance is released, the working group can review and identify potential outstanding research questions.
  • Suggestion to have follow-up working group calls every 2-3 months, with each call being focused on issues surrounding a specific MARPs sub-population.
  • Don DesJarlais volunteered to co-chair; Rich Needle will serve as the OGAC counterpart.
  • Agenda and relevant articles to be circulated by Don and members of the working group in advance of the next call/meeting. OGAC to facilitate logistics.
  • Rich can share updates from PEPFAR including a report out from upcoming regional meetings for implementing the latest guidance.
  • Presentation and update to be made by the MARPs working group at the next PEPFAR SAB meeting.
  • Next MARPs working group call to be scheduled April 2011.

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