- Alternatives to punishment
- Harm reduction
Achieving the desired prevention results often depends on additional efforts to create a conducive policy environment for prevention and address a range of factors that increase vulnerability or hinder HIV prevention service demand, access, uptake and adherence. These include punitive laws, policies and practices related to sex work, same-sex relations, and drug use and possession for personal use; stigma and discrimination, including in health-care settings; and restrictions on health services in prisons. Young people, especially adolescent girls and young women, also face many barriers in accessing comprehensive sexuality education and health and HIV services, for example due to age-of-consent policies that restrict access of adolescents to contraception, HIV testing and condoms. Extraordinary efforts are also required in humanitarian situations to ensure that people affected are protected against violence, including sexual violence, and have access to HIV prevention and treatment services and commodities.
Combination prevention programmes for all key populations that are evidence informed and human-rights-based, including community empowerment, peer outreach and condom distribution, harm-reduction services for people who use drugs, and access to stigma- and discrimination-free HIV testing and referral to treatment. Strengthened programmes should be implemented at scale, community-based and community-led, and tailored to the HIV and wider sexual and reproductive health needs of key populations.