Demand for programs for key populations in Africa from countries receiving international donor assistance

There has been increasing attention in recent years to the HIV prevention, treatment, and care needs of key populations in Africa, in particular men who have sex with men (MSM), injection drug users (IDU), and female sex workers (FSW). While several major donors have undertaken efforts to prioritize these groups, it remains unclear which African countries are actively seeking donor support for these programs. For this analysis, we reviewed publicly available proposal and budget documentation from the US PEPFAR for fiscal years 2007 through 2010 and Rounds 1 through 10 of the Global Fund to Fight AIDS, Tuberculosis and Malaria for 40 countries in sub-Saharan Africa. Of the 164 searchable documents retrieved, nearly two-thirds contained at least one program serving FSW (65%, 107 proposals), less than one-third contained at least one program serving MSM (29%, 47 proposals), and a minority proposed programming for IDU (13%, 21 proposals). Demand for these programs was highly concentrated in a subset of countries. Epidemiological data for at least one key population was included in a majority of these proposals (63%, 67 proposals), but in many cases these data were not linked to programs.