The burden of an HIV epidemic in Kosovo* lies among the key populations (KPs) of female sex workers (FSWs), men who have sex with men (MSM), and people who inject drugs (PWIDs). The aim of this study was to estimate the size and distribution of these populations to create evidence for developing action plans for HIV prevention.
Results of this Study: 
Of the estimated 6814 men who have sex with men (range: 6445 to 7117), nearly 4940 operate through the internet owing to the large stigma and discrimination against same-sex relationships. Geo-based men who have sex with men (who operate through physical spots) congregate at a few spots with large spot sizes (13.3 men who have sex with men /spot). Three-fourths of the men who have sex with men are distributed in 5 major municipalities. Fridays and Saturdays are the peak days of operation; however, the number only increases by 5%. A significant number are involved in sex work, that is, provide sex to other men for money. People who inject drugs are largely geo-based; 4973 (range: 3932 to 6015) people who inject drugs of the total number of 5819 (range: 4777 to 6860) visit geographical spots, with an average spot size of 7.1. In smaller municipalities, they mostly inject in residential locations. The numbers stay stable during the entire week, and there are no peak days. Of the 5037 (range: 4213 to 5860) female sex workers, 20% use cell phones, whereas 10% use websites to connect with clients. The number increases by 25% on weekends, especially in larger municipalities where sex work is mostly concentrated. Other than a few street-based spots, most spots are establishments run by pimps, which is reflective of the highly institutionalized, structured, and organized female sex workers network.
This study provides valuable information about the population size estimates as well as dynamics of each KP, which is the key to developing effective HIV prevention strategies. The information should be utilized to develop microplans and effectively provide HIV prevention services to various KPs.
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