The head of a female sex worker cooperative who also works as an outreach worker conducts a street session in Ethiopia on how to use a condom correctly.

Photo Credit: Henock Alemayehu/Timret Lehiwot Ethiopia

The Linkages across the Continuum of HIV Services for Key Populations Affected by HIV project, also known as LINKAGES, is the first U.S. Agency for International Development (USAID)-funded project that works within the mandate to focus on HIV services specifically for key populations. Key populations are people who inject drugs, men who have sex with men, transgender persons, sex workers and prisoners.

LINKAGES aims to accelerate the ability of partner governments, key population-led civil society organizations and private-sector providers to plan, deliver and optimize comprehensive HIV prevention, care and treatment services to reduce HIV transmission among key populations and help those who are HIV positive live longer.

LINKAGES enhances HIV prevention and care by improving the outreach to key populations most at-risk of acquiring or transmitting HIV; promoting routine HIV testing and counseling; actively enrolling those with HIV into care and support interventions; and enabling them to remain in care. The project also helps countries use and scale up evidence-based approaches to service provision; helps key populations mobilize and advocate for changes in laws and the conduct of police, healthcare workers and policymakers; and work with governments to make programs sustainable for the long term.  

High-quality, accessible services and sustained responses are driven through community networks to ensure that the rights of key populations, including those living with HIV and AIDS, are respected and the most impact is achieved.

LINKAGES' Impact on Key Populations

• Access to better quality, more integrated HIV prevention, care and treatment services in welcoming settings that protect the privacy of key populations
• Support from trained peers who can help key populations access HIV testing and counseling and other HIV services, legal aid, mental health and nutrition support and economic opportunities
• Healthcare workers who understand and address their needs in a non-stigmatizing way
• Safer communities with stronger crisis response systems and reduced gender-based and other forms of violence
• Meaningful opportunities to have key populations community members' input in how services are delivered, improved and evaluated
• Evidence-based information that empowers key populations to make decisions that lead to better health
• Reduced threat of criminal prosecution under discriminatory laws

LINKAGES Achievements

LINKAGES' reach and scope has continued to exceed expectations. To date, LINKAGES has issued grants to more than 90 partners throughout multiple regions and countries around the world. Currently, direct service programming and/or technical assistance activities are being implemented with key population-led organizations, other non-governmental organizations, public health facilities and ministries of health in the following countries:

LINKAGES also serves as a global thought leader on HIV and key populations programming, bringing together experts on key populations issues, translating research and data into evidence-based programming and developing tools for implementers to use. In all instances, LINKAGES collaborates with various key population-led organizations and networks at the local, regional and global level.

Additional Resources

• LINKAGES HIV Cascade Framework for Key Populations
• LINKAGES Key Population Program Implementation Guide [PDF, 1.5MB]
• MSMIT: A Comprehensive Guide for Implementing Sexual Health Interventions with Men Who Have Sex with Men
• TRANSIT: Implementing Comprehensive HIV Prevention Programmes with Transgender People
• SWIT: Implementing Comprehensive HIV/STI Programmes with Sex Workers: Practical Approaches from Collaborative Interventions
• Success Story: Thai HIV Clinics Target High-Risk Groups to Promote Testing
• Success Story: Dominican Republic Activists Work to Advance Transgender Health Care
• Success Story: Reducing HIV/AIDS Risk in Ukraine for Injection Drug Users