Ghana's National AIDS Commission reported that innovative peer counseling programs delivered by groups like the West Africa Program to Combat AIDS and STI (WAPCAS) helped to lower HIV incidence among Ghana's sex workers from 37.8 percent in 2006 to 11.2 percent in 2012. Overall HIV prevalence in Ghana is 1.5 percent. WAPCAS services -- prevention, counseling, free HIV testing, and referrals to care -- target sex workers, HIV-infected individuals, men who have sex with men (MSM), and injection drug users. WAPCAS's chief goals included raising awareness of HIV and sexually transmitted infections and "teaching people how to avoid them."
Sex work and gay sex are illegal in Ghana, which makes MSM and sex workers vulnerable, since they have no legal recourse to abuse and exploitation. WAPCAS educators believed outreach had been successful because peer educators had the target audience's interests at heart. As a result, sex workers had a better understanding and more confidence in practicing safer sex with male or female condoms.
Working with MSM and lesbians is more complicated because of social stigma and Ghana's religious and cultural norms. HIV prevalence among MSM is 25 percent. According to Nii Akwei Addo, head of Ghana's National AIDS Control Programme, anti-HIV groups had to strike a balance that helped MSM practice safer sex without encouraging MSM sex. The Ghana Centre for Popular Education and Human Rights has conducted successful MSM peer educator programs and reported that increased access to antiretroviral therapy, HIV testing, counseling, and referrals helped to lower HIV deaths among MSM within the last four years.
Other vulnerable populations comprised sex workers' non-paying partners such as spouses and former clients. Additionally, some MSM might take heterosexual partners to conceal their sexual preference, which puts those partners at risk. Akwei Addo confirmed the importance of taking services to these vulnerable populations and encouraging safer sex.