Transforming the response to the HIV epidemics amongst key populations: Addressing structural factors for achieving HIV elimination

Despite international efforts to eliminate HIV/AIDS, infection levels remain high among key populations (KPs). Although effective interventions exist, evolving evidence suggests structural factors limit their impact and increase HIV transmission among KPs. Initiatives to reduce these factors (societal enablers) are a focus of new global HIV elimination strategies, but little evidence exists on the contribution of structural factors to HIV transmission or the potential impact of societal enablers. The proposed research will develop a novel evidence-based statistical and modelling framework to improve this evidence base. We will conduct epidemiological analyses to improve our quantitative understanding of the causal pathways between structural factors and HIV-risk, utilising global longitudinal datasets. We will then develop new mathematical models that include these causal pathways to robustly estimate the contribution of structural factors to HIV transmission and evaluate the impact and cost-effectiveness of societal enablers across diverse KPs and countries. The project will transform the evidence and methodologies used to evaluate the effect of structural factors and interventions to mitigate their effects. It will result in a step change through enabling evidence-based planning for including societal enablers in HIV programming for KPs, with insights being crucial for national/global policymakers aiming to eliminate HIV/AIDS by 2030.