This systematic review suggests that the concentrated HIV
epidemic in WCA more closely resembles the epidemics in
Southeast Asia and Latin America than those in the rest of
SSA. This not only calls into question the response to the
HIV epidemic in WCA but indicates that the region has an
opportunity to adapt and develop region-specific prevention
and treatment strategies. Targeted, cost-effective programmes
that address not only behavioural but also biological
and structural risk factors associated with HIV acquisition and
transmission key populations should be engaged to reduce the
onward spread of HIV. Prevention programmes should model
strategies on appropriate programmes that reduce community
viral loads, increase uptake of treatment among key
populations and address the barriers to healthcare that exist in
highly stigmatized settings. Ensuring that programmes rooted
in community-based approaches address the continuum of HIV care, from diagnosis to viral suppression, will be a
challenge but also a possible victory for HIV prevention and
control in WCA.