Key Populations

The Issue

Despite major progress in South Africa’s HIV response, Key Populations (KPs) and Vulnerable Groups (VGs)—including female sex workers, men who have sex withmen, people who inject drugs, and adolescent girls and young women—remain disproportionately affected. The barriers they face are rooted not in a lack of medication, but in powerful structural drivers: punitive laws, persistent social stigma, gender inequality, discrimination, violence, and health services that are often unwelcoming or unsafe. These challenges are compounded by gaps in basic health worker training, which can lead to secondary stigma within healthcare settings and discourage engagement with HIV testing, prevention (such as PrEP), and treatment (ART).

The Intervention

CRH works with government, civil society, and community partners to co-develop evidence-based, tailored service interventions that directly address these structural barriers. This includes policy advocacy to reduce legal and social obstacles, strengthen human rights protections, and improve access to differentiated services for KPs and VGs. A core component is the development and implementation of specialised, affirming health worker curricula. These training programmes aim to ensure that all healthcare workers deliver competent, non-discriminatory, and respectful care, creating a safer and more inclusive environment across the health system.

The Impact

By focusing on the root causes of vulnerability, this work drives measurable, high-value impact aligned with South Africa’s National Strategic Plan for HIV, TB, STIs (2023-2028). Improved service access and reduced stigma lead to increased HIV testing, higher PrEP uptake, improved ART adherence, and more consistent engagement in care among KPs and VGs. Equally importantly, the initiative strengthens human rights by promoting equitable, affirming, and dignified healthcare for all—regardless of identity, occupation, or circumstance.

Project Information

Project Leads

Prof. Zamasomi Luvuno

Co-Leads

Dr. Hlolisile Chiya

Project Team

Prof. Busisiwe Ncama
Prof. Sinegugu Duma
Prof. Deshni Naidoo
Dr. Silingene Ngcobo

Project Timeline

Ongoing

Funders

Self-funded

Collaborators and Partners

Collaborators:
Prof. Serwa Omowale (UTHealth Houston School of Public Health)
Dr. Themba Nxumalo(University of Western Cape)
Prof. Orlando Harris(University of California, San Franscisco)
Prof. Sophia Zamudio-Haas(University of California, San Franscisco)

Partners:
Office of the Premier KwaZulu-Natal
South Africa National Aids Council(SANAC)
The National Department of Health (HIV, AIDS and STIs Unit)

Project Keywords

LGBTQIA+
Female sex workers
Prisoners
Transgender men
People who use drugs and men who have sex with men