Scale-up of HIV Services for Key Population in Mozambique, 2020–2023

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Abstract Introduction Mozambique provides targeted services to reduce HIV incidence and improve clinical outcomes among key populations (KP), including female sex workers (FSW), men who have sex with men (MSM), prisoners, and people who inject drugs (PWID). KP program data were analyzed to understand achievements since 2020 and remaining gaps. Methods We analyzed PEPFAR Monitoring, Evaluation, and Reporting routine aggregate data available for 2020–2023. KPs on antiretroviral therapy (ART) were defined as clients with ≤28 days since the last missed visit. The test positivity rate was calculated as positive tests over tests conducted. The viral load suppression (VLS) rate was calculated as KP with VLS (<1,000 copies/mL) among those tested in the past 12 months. Data were analyzed by fiscal year (October–September) and KP sub-group. Results During 2020–2023, tests conducted increased by 176% (43,834 to 121,184), positive tests increased by 33% (10,412 to 13,883) and test positivity was 17% (56,494/333,194); KP newly initiated on ART increased by 198% (3,979 to 11,875); and KP on ART increased by 370% (8,042 to 37,779). Among KP on ART in September 2023, 25,900 (69%) were FSW, 6,601 (17%) were MSM, 4,078 (11%) were prisoners, and 1,200 (3%) were PWID; VLS rate was 94% (23,224/24,723); 94% among FSW (16,451/17,551), 95% among MSM (4,195/4,419), 94% among prisoners (1,837/1,956), and 93% among PWID (741/797). Conclusion The successful scale-up of KP services in Mozambique since 2020 has increased the number of KP tested, initiated, and sustained on treatment, with high VLS rates. This indicates the positive impact of services among KP, contributing to reaching HIV epidemic control nationally.