Contextual Background

The HIV epidemic in the Pacific region is characterised as low prevalence. However, despite the low overall rates of infection, the region is vulnerable to an increasing HIV epidemic. This is due to several factors, including inadequate data on key populations, limited awareness and understanding amongst policy makers of the epidemic’s potential long-term impact, unsupportive policy and legal environments, inadequate health systems, presence of stigma and discrimination against certain vulnerable groups, and low levels of community capacity and engagement in the policy making and programme implementation.

Project Focus

The study, titled Pacific Multi-Country Mapping and Behavioural Study: HIV and STI Risk Vulnerability among Key Populations, was a joint study by ASHM, UNDP, UNICEF and the University of New South Wales. Through surveys and in-depth interviews aimed to assess and examine the behaviour risk factors and social and structural determinants of HIV risk that drive the epidemic among vulnerable groups, such as men who have sex with men (MSM), transgender people, female sex workers and seafarers. This study was commissioned by UNDP Pacific and the Pacific Regional Multi-Country Coordinating Mechanism and funded by The Global Fund to Fight AIDS, TB and Malaria

In addition to collecting data on behaviour, the study also conducted population size estimates in each of the nine Pacific Island countries and territories (PICT), filling a gap needed for effective public health programme design and planning.

ASHM's International Program, Michelle O'Connor led the study in Tonga and Tuvalu working with local organisations to collect quanitative and quantitative data.

Location Scope

The study covers nine Pacific countries: Cook Islands, Federated States of Micronesia, Kiribati, Palau, Republic of the Marshall Islands, Samoa, Tonga, Tuvalu, Vanuatu

Project Timeline



The published findings in Pacific Multi-Country Mapping and Behavioural Study: HIV and STI Risk Vulnerability among Key Populations indicate an urgent need for reforms in Pacific island countries to adequately address HIV and sexually transmitted infections (STIs) among vulnerable populations. Important findings could be used to guide policy, services and programs for vulnerable populations in PICTs, including recommendations to introduce or scale up peer education, condom distribution and outreach programs for MSM, transgender and female sex workers.

The studies found that many people are not receiving adequate sexual health and HIV services, support and information, for example between 0% to 59% of MSM and transgender reported accessing HIV services within the last 12 months. The study shows that one of the key challenges faced in the small island countries is the stigma and lack of acceptance of MSM, Transgender and FSW.


The data produced from the study will be used by countries to support their regional and global reporting obligations and to inform national and regional planning, as well as to empower vulnerable groups to mount strong advocacy cases for change. A key finding of the study was the need for more inclusive services and programmes. 

“This research quantifies and reaffirms most of the information and knowledge that we in the community already know about the stigma and discrimination that is faced by men who have sex with men, transgender persons and sex workers in the Pacific. It will provide a crucial basis on which we will build and strengthen interventions,” said Isikeli Tumaiwakaya Vulavou, Pacific Sexual Diversity Network, a regional civil society group advocating for human rights of key populations. “The ‘zero goals’ of zero new HIV infections and zero AIDS-related deaths will not be achieved unless we reduce stigma and discrimination to zero.” 

The key take home message emerged from the report demonstrates that the differences existing between each country leads to a conclusion that a one-size-fits-all approach to improving access to HIV and STI services would not work and as such each requires a response tailored to each respective situation and country.

Download the Pacific Multicountry Mapping and Behavioural Study Key Findings​ (Infographics)

A summary of the key findings and the individual country reports can be viewed below:

Download the Pacific Multicountry Mapping and Behavioural Study Key Findings​ (Reports)

Contact Details

For any general enquiries relating to this project, please contact:

Michelle O'Connor  |  ASHM International HIV&SRH Program Adviser  |  +61 2 8204 0736