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To achieve the UNAIDS targets at a national level, many countries must accelerate service coverage among key populations. To do this, key population programs have adopted methods similar to those used in respondent-driven sampling RDS to expand reach. A deeper understanding of factors from RDS surveys that enhance health service engagement can improve key population programs. To understand the in-depth lives of key populations, acceptance of expanded point-of-care biological testing and determine drivers of participation in RDS surveys, we conducted semi-structured interviews with key population participants 12โ€”65 years were purposefully selected from six biobehavioral surveys BBS in three cities in Papua New Guinea.

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Key populations were female sex workers, men who have sex with men, and transgender women. Biobehavioral surveys, and programs offering key population services can incorporate the approach we used to facilitate key population engagement in the HIV cascade.

Despite several decades of intense global prevention and treatment efforts against HIV, curable sexually transmitted infections STIs , and tuberculosis TB , these diseases continue to cause an unacceptable burden of disease among key populations and their communities who also experience substantial social stigma and exclusion [ 1 ]. HIV incidence among key populations was 13 to 28 times higher than among other comparable groups [ 2 ].

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Sexual behaviors that increase risk of HIV among key populations also increase risk for STIs and other bloodborne viruses [ 2 ]. If left untreated, these infections, including syphilis, gonorrhea, and chlamydia, can have adverse sexual and reproductive outcomes. As with other infectious diseases, TB disproportionately affects the most vulnerable: for example, people living with HIV are 21 times more likely to develop TB than HIV-negative individuals [ 3 , 4 ].

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