ArticleThe Lancet. Global health2024
Population size, HIV prevalence, and antiretroviral therapy coverage among key populations in sub-Saharan Africa: collation and synthesis of survey data, 2010-23.
Article in The Lancet. Global health, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 33 papers, 4 of them syntheses that pooled it.
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Who cites it
33 citing papers in PubMed, 4 syntheses or guidelines pooled it.
- Prospects of HIV elimination among men who have sex with men: A systematic review of modeling studies.PLoS computational biology · 2026Pooled it
- HIV prevalence in transgender women and cisgender men who have sex with men in sub-Saharan Africa.AIDS (London, England) · 2026Pooled it
- HIV incidence among women engaging in sex work in sub-Saharan Africa: a systematic review and meta-analysis.The Lancet. Global health · 2024Pooled it
- Trends in HIV testing, the treatment cascade, and HIV incidence among men who have sex with men in Africa: a systematic review and meta-analysis.The lancet. HIV · 2023Pooled it
- Acceptability and feasibility of a urine-based tenofovir adherence assay for monitoring and providing feedback on PrEP adherence in Kenya.AIDS care · 2025Trial
- A risk-differentiated, community-led intervention to strengthen uptake and engagement with HIV prevention and care cascades among female sex workers in Zimbabwe (AMETHIST): a cluster randomised trial.The Lancet. Global health · 2024Trial
- Predicting the spatiotemporal evolution of HIV/AIDS in Africa: A retrospective analysis of epidemiological trends.Infectious Disease Modelling · 2026Article
- HIV Seroprevalence, Incidence, and Viral Suppression Among Ugandan Female Bar Workers: A Population-Based Study.Journal of acquired immune deficiency syndromes (1999) · 2026Article
- Review
- The Association Between HIV and Substance Use Stigma and Attitudes and Utilization of HIV Care Among Adults Who Use Injection Drugs: A Systematic Review.AIDS and behavior · 2026Article
- Parkinsonism in people with virally suppressed HIV.The lancet. HIV · 2026Review
- Gender differences in social networks of women and men who inject drugs in Kenya.The International journal on drug policy · 2026Article
- Age, sex-and what else? Rethinking priorities to close gaps in the HIV care cascade.Journal of the International AIDS Society · 2026Article
- Geospatial Approaches to HIV Care: a Scoping Review of Asset Mapping.Current HIV/AIDS reports · 2026Article
- Identifying priority populations for HIV interventions using acquisition and transmission indicators: a combined analysis of 15 mathematical models from ten African countries.The lancet. HIV · 2026Article
- Leveraging injection networks to prevent HIV and other blood borne infections among people who inject drugs in Kenya: design and rationale.BMC infectious diseases · 2025Article
- Impact and cost-effectiveness of the community-led AMETHIST intervention among female sex workers in Zimbabwe.Nature communications · 2025Article
- Feasibility and acceptability of peer-led assessment of HIV risk among female sex workers in Zimbabwe.BMJ global health · 2025Article
- SARS-CoV-2 Evolution in an HIV-Endemic Setting: A Genomic Epidemiology Study from Botswana.medRxiv : the preprint server for health sciences · 2025Article
- Differential risk for Hepatitis C and HIV among people who inject drugs in Kenya: a latent class analysis signaling needs for innovation in service delivery.The International journal on drug policy · 2025Article
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27 authors.
Funding
Abstract
backgroundKey population HIV programmes in sub-Saharan Africa require epidemiological information to ensure equitable and universal access to effective services. We aimed to consolidate and harmonise survey data among female sex workers, men who have sex with men, people who inject drugs, and transgender people to estimate key population size, HIV prevalence, and antiretroviral therapy (ART) coverage for countries in mainland sub-Saharan Africa.
methodsKey population size estimates, HIV prevalence, and ART coverage data from 39 sub-Saharan Africa countries between 2010 and 2023 were collated from existing databases and verified against source documents. We used Bayesian mixed-effects spatial regression to model urban key population size estimates as a proportion of the gender-matched, year-matched, and area-matched population aged 15-49 years. We modelled subnational key population HIV prevalence and ART coverage with age-matched, gender-matched, year-matched, and province-matched total population estimates as predictors.
findingsWe extracted 2065 key population size data points, 1183 HIV prevalence data points, and 259 ART coverage data points. Across national urban populations, a median of 1·65% (IQR 1·35-1·91) of adult cisgender women were female sex workers, 0·89% (0·77-0·95) were men who have sex with men, 0·32% (0·31-0·34) were men who injected drugs, and 0·10% (0·06-0·12) were women who were transgender. HIV prevalence among key populations was, on average, four to six times higher than matched total population prevalence, and ART coverage was correlated with, but lower than, the total population ART coverage with wide heterogeneity in relative ART coverage across studies. Across sub-Saharan Africa, key populations were estimated as comprising 1·2% (95% credible interval 0·9-1·6) of the total population aged 15-49 years but 6·1% (4·5-8·2) of people living with HIV.
interpretationKey populations in sub-Saharan Africa experience higher HIV prevalence and lower ART coverage, underscoring the need for focused prevention and treatment services. In 2024, limited data availability and heterogeneity constrain precise estimates for programming and monitoring trends. Strengthening key population surveys and routine data within national HIV strategic information systems would support more precise estimates.
fundingUNAIDS, Bill & Melinda Gates Foundation, and US National Institutes of Health.
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