J. Hung, A. Smith
We constructed a balanced panel covering eight Southeast Asian countries over 2018 to 2025 from the UNAIDS Global AIDS Monitoring (GAM) framework.
Introduction. Empirical evidence linking the existence of national structural policies to the provision of key HIV services in low- and middle-income settings remains scarce. This study addresses the research gap by quantifying the within-country relationships between six national structural policy indicators and the presence of the HIV prevention service component targeted at sex workers. Methods. We constructed a balanced panel covering eight Southeast Asian countries over 2018 to 2025 from the UNAIDS Global AIDS Monitoring (GAM) framework. For each country and year, the panel records the government's reported status on six policy indicators, namely (1) any HIV prevention service component targeted at sex workers, (2) barriers to accessing social protection among people living with HIV and key populations, (3) coordination between social protection and the national AIDS programme, (4) national implementation guidelines for HIV prevention programmes for sex workers, (5) a social protection policy addressing unpaid care work, and (6) a social protection policy recognising adolescent girls and young women as key beneficiaries. We used Fixed-Effects (FE) and Random-Effects (RE) models, with the FE model selected as the more statistically appropriate estimator, and one-period lagged explanatory variables. Results. The primary finding from the FE model indicated a statistically significant and positive contemporaneous association between the existence of legal or administrative barriers to social protection and the presence of HIV prevention services for sex workers ({beta} = 0.8531; p < 0.001). However, the robustness check revealed a statistically significant negative association when using the lagged barrier variable ({beta} = -0.3540; p = 0.011). No other indicator's coefficient was statistically significant in the FE models. Conclusions. The sustained presence of these impediments over time is associated with the absence of HIV prevention service provision in the following year. National HIV programmes must urgently prioritise the removal of structural barriers for key populations.