Middle-income countries that are transitioning away from external donor funding for HIV services targetting key populations need to have policies in place and domestic resources allocated to continue providing the services sustainably without disruption. We analyzed and presented the findings from the surveys and key informant interviews of diverse stakeholders to understand barriers to domestic funding for key population–led HIV programming in four selected countries (Bhutan, Mongolia, the Philippines, Sri Lanka) in Asia that are scheduled for transition.

PrEP uptake remains low among MSM in mainland China and Hong Kong. This study found that oral PrEP was most preferred, with MSM in mainland China more likely to use on-demand PrEP, whereas MSM in Hong Kong were more likely to use monthly oral PrEP. These findings highlight the need for specific strategies to improve PrEP uptake and address local social and behavioural influences on HIV prevention.

This article belongs to the collection: Awareness, Preferenes, and the Use of PrEP in Asia Among Men Who Have Sex With Men Findings from the PrEP APPEAL Study.

Despite evidence that many middle-aged and older adults in the UK remain sexually active, their access to and uptake of sexual health services has been underestimated. Our exploration of their lived experiences revealed physical barriers and the stigma around their sexual health and of being perceived as asexual by health professionals. To improve service provision and access, a multi-faceted approach is needed, including enhanced training for healthcare providers, further research, and supportive policies.

This article belongs to the collection: Sexual health among older adults: A multi-disciplinary collection.

Using doxycycline after exposure (doxycycline post-exposure prophylaxis) can prevent men who have sex with men from contracting STIs. A study in Taiwan found that these men were open to using doxycycline post-exposure prophylaxis, especially when they felt that they might be at risk of STIs. It is important to understand their readiness to identify behaviors that increase the chances of contracting or transmitting STIs, and to offer education and support to help them use doxycycline post-exposure prophylaxis effectively.

This study highlights the importance of community involvement in HIV research, particularly among marginalized groups, such as young gay, bisexual, and queer men in Singapore and Malaysia. A collaborative project between the National University of Singapore and a local organization, RainbowAsia, used a citizen-led approach to overcome funding challenges and stigma. The research focused on issues, such as mental health and relationships, relying on community resources and volunteers. The proposed framework includes eight phases for effective collaboration, aiming to transform research into impactful community programs.

This survey of 27 Australian sexual health clinics about their services in 2023 found they offered a median of 35 bookings each day, but only a median of 10 walk-in consultations for symptomatic patients. Only approximately half of clinics could provide services to all individuals with symptoms who attended each day. The catchment population of the clinics ranged from as low as 3696 to a maximum of 5 million. Turing away individuals with symptoms will impede effective STI control.

STIs remain a key concern in the context of HIV biomedical prevention. In a study of 343 male HIV-serodiscordant couples in Australia, Brazil and Thailand, we found higher rates of STI diagnosis for HIV-positive partners compared with their HIV-negative regular partners, and couples were typically not diagnosed with an STI together. HIV transmission risk has been eliminated for HIV-serodiscordant couples where the HIV-positive partner has a supressed viral load; however, other STIs continue to be diagnosed.

Adolescents and young adults (AYA) play a key role in shaping sustainable HIV prevention services, yet they do not have many opportunities to contribute to these efforts. To address this challenge, we organized a crowdsourcing open call and identified four key strategies – AYA engagement and leadership in research, digital health solutions, financing and efficiency, and partnerships. These findings demonstrate how engaging AYA can transform HIV prevention efforts, ensuring they meet the needs of AYA.

Treatment coverage, viral load suppression and survival rates among adolescents living with HIV are lagging behind other groups, and yet adolescents are rarely involved in shaping HIV programs and policies. Adolescents and young people in our study suggested leveraging education and entertainment, new digital technologies, such as unstructured supplemental service delivery, and peer-based interventions to improve HIV outcomes. These ideas offer actionable steps for HIV policymakers to develop more effective programs that center the adolescent experience and perspective.