Some countries have national guidelines in some form that speak to sexual and reproductive health provisions for sexual and gender minorities, and/or sex workers, although each has limitations. Generally, where national guidelines do exist, they are policy documents or strategic frameworks, not specifically service standards and clinical care protocols. Where the latter exist in any form, they are cis-gendered and heteronormative, despite the strong emphasis placed on Key Populations in National Strategic Plans for HIV, by the same government department responsible for health.


Certain non-governmental civil society organisations and programmes have developed operational and clinical guidelines and service standards for sexual and reproductive health of Key Populations. But National Strategic Plans for HIV Response, for example, suggest little evidence that any country has plans to develop national clinical or service guidelines that would illustrate comprehensive, appropriate, integrated, differentiated care for men who have sex with men, women who have sex with women, trans people or sex workers who may use public health services for their sexual and reproductive health needs.