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

Purpose:

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 http://www.pepfar.gov/documents/organization/144970.pdf
• 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.