While global prevalence of HIV infection (percentage of persons infected with HIV) appears to have stabilized in recent years, the global number of people living with HIV is increasing because of ongoing accumulation of new infections with longer survival times, measured over a continuously growing general population.
Across the world, a small but growing number of countries have reduced HIV prevalence through sound prevention efforts. The high rates of transmission of HIV result largely from failure to use the available and effective prevention strategies and tools, and poor coverage of HIV prevention programmes. HIV prevention services were only reaching 20% of people in need in 2005, while coverage for key populations at higher risk of exposure to HIV were considerably lower.
Effective HIV prevention programming focuses on the critical relationships between the epidemiology of HIV infection, the risk behaviours that expose to HIV transmission, and also addresses the collective social and institutional factors, such as sexual norms, gender inequality, and HIV related stigma, that will otherwise continue to fuel HIV epidemic.
Risk behaviours are enmeshed in complex webs of economic, legal, political, cultural and psychosocial determinants that must be analyzed and addressed by policies that are also effectively implemented, and through scaled-up programming.
Comprehensive HIV prevention requires a combination of programmatic and policy actions that promote safer behaviours, reduce vulnerability to transmission, encourage use of key prevention technologies, promote social norms that favor risk reduction and address drivers of the epidemic.
Effective prevention efforts focus on measures that directly support risk reduction by providing information and skills as well as access to needed commodities (such as condoms, sterile injecting equipment, and drug substitution therapy) for the populations most in need. In short, national planners and policymakers must: 1) Know their epidemic; and 2) Set priorities accordingly.
Prevention and treatment must be scaled up in a balanced way, to capitalize fully on synergies between the two. Comprehensive HIV prevention requires a combination of programmatic interventions and policy actions that promote safer behaviours, reduce biological and social vulnerabilities to transmission, encourage use of key prevention technologies, and promote social norms that favour risk reduction.
HIV prevention includes addressing an array of issues discussed in other thematic areas in the policy section of the website. Forging links among HIV prevention with related programmes and services such as sexual and reproductive health services and legal services for women, can also contribute to intensification of HIV prevention. Strong linkages as well as special efforts to reach those at higher risk and excluded from access to services will result in more relevant and cost-effective programmes with greater impact.
Essential Policy Actions for HIV Prevention
- Ensure that human rights are promoted, protected and respected and that measures are taken to eliminate discrimination and combat stigma.
- Build and maintain leadership from all sections of society, including governments, affected communities, nongovernmental organizations, faith-based organizations, the education sector, media, the private sector and trade unions.
- Involve people living with HIV, in the design, implementation and evaluation of prevention strategies, addressing the distinct prevention needs.
- Address cultural norms and beliefs, recognizing both the key role they may play in supporting prevention efforts and the potential they have to fuel HIV transmission.
- Promote gender equality and address gender norms and relations to reduce the vulnerability of women and girls, involving men and boys in this effort.
- Promote widespread knowledge and awareness of how HIV is transmitted and how infection can be averted.
- Promote the links between HIV prevention and sexual and reproductive health.
- Support the mobilization of community-based responses throughout the continuum of prevention, care and treatment.
- Promote programmes targeted at HIV prevention needs of key affected groups and populations.
- Mobilizing and strengthening financial, and human and institutional capacity across all sectors, particularly in health and education.
- Review and reform legal frameworks to remove barriers to effective, evidence based HIV prevention, combat stigma and discrimination and protect the rights of people living with HIV or vulnerable or at risk to HIV.
- Ensure that sufficient investments are made in the research and development of, and advocacy for, new prevention technologies.
The latest from the GCWA
15 Nov, 2009|
Prevention-microbicides: Safety and pharmacokinetics of dapivirine delivery from matrix and reservoir intravaginal rings to HIV-
Vaginal microbicides for the prevention of HIV transmission may be an important option for protecting women from infection. Incorporation of dapivirine, a lead candidate nonnucleoside reverse transcriptase inhibitor, into intravaginal rings (IVRs) for sustained mucosal delivery may increase microbicide product adherence and efficacy compared with conventional vaginal formulations. Twenty-four healthy HIV-negative women 18-35 years of age were randomly assigned (1:1:1) to dapivirine matrix intravaginal ring, dapivirine reservoir intravaginal ring, or placebo intravaginal ring.
15 Nov, 2009|
Prevention-Microbicides: Maraviroc concentrates in the cervicovaginal fluid and vaginal tissue of HIV-negative women
The authors compared single- and multiple-dose maraviroc exposures in cervicovaginal fluid (CVF) and vaginal tissue (VT) with blood plasma (BP) and quantified maraviroc protein binding in cervicovaginal fluid. In this open-label pharmacokinetic study of 12 HIV-negative women, 7 paired CVF and BP samples were collected over 12 hours after 1 maraviroc dose. Subjects then received maraviroc twice daily for 7 days. After the last dose, subjects underwent cervicovaginal fluid and blood plasma sampling as on day 1, with additional sampling during terminal elimination.
9 Nov, 2009|
WHO Women and Health. Today's evidence, tomorrow's agenda
9 Nov, 2009|
Hay dos cosas que la ghanesa Kate Adoo-Adeku tiene claras: que "el sida no se combate sólo con medidas sanitarias. La educación es un factor clave", y que todavía no hay un método de protección pensado para las mujeres, aunque éstas son la mayoría de las infectadas por el VIH en el África subsahariana, la región del mundo que concentra a un 70% de los afectados. Y alrededor de esas dos ideas clave se mueve.
9 Nov, 2009|
GCWA partner / women and health : WHO calls for action beyond the health sector to improve the health of girls and women
Despite considerable progress in the past decades, societies continue to fail to meet the health care needs of women at key moments of their lives, particularly in their adolescent years and in older age, a WHO report has found. Launching the report, entitled Women and health: today's evidence tomorrow's agenda, WHO Director-General, Dr Margaret Chan called for urgent action both within the health sector and beyond to improve the health and lives of girls and women around the world, from birth to older age. "If women are denied a chance to develop their full human potential, including their p
7 Nov, 2009|
Studies in Asia indicate that most women in the region acquire HIV because of their partners who engage in unsafe behaviours. It is estimated that more than 90% of women living with HIV acquired the virus from their husbands or boyfriends while in long-term relationships.
29 Oct, 2009|
Zimbabwe / prevention: Empowering women to protect themselves: Promoting the female condom in Zimbabwe
When AIDS first emerged in the 1980s, it mainly affected men. Today, according to UNAIDS figures, women account for about half of the 33 million people living with HIV worldwide, and 60 per cent of those infected in sub-Saharan Africa. Most of these women acquired the virus through heterosexual intercourse, often through unprotected sex with their husbands or long-term primary partners. “Women think marriage is a safe haven,” says Beauty Nyamwanza of Zimbabwe’s National AIDS Council.
26 Oct, 2009|
China / Prevention-PMTCT: A case series of 104 women infected with HIV-1 via blood transfusion postnatally: high rate of HIV-1 t
Liang and colleagues investigated transmission of human immunodeficiency virus type 1 (HIV-1) via breast-feeding by 104 Chinese mothers who acquired the infection through blood transfusion postnatally. Of 106 children, 38 (35.8%) were infected. All children survived to age 5 years, and their survival curve was similar to that of their mothers.
26 Oct, 2009|
This article describes a review of 58 evaluation studies of programmes with men and boys in sexual and reproductive health (including HIV prevention, treatment, care and support); father involvement; gender-based violence; maternal, newborn and child health; and gender socialisation more broadly. While few of the programmes go beyond the pilot stage, or a relatively short-term timeframe, they offer compelling evidence that well-designed programmes with men and boys can lead to positive changes in their behaviours and attitudes related to sexual and reproductive health; maternal, newborn and c
26 Oct, 2009|
South Africa / Young people: Early coital debut and associated HIV risk factors among young women and men in South Africa
Young people in South Africa are at high risk of HIV infection. Because first sexual experiences may influence a young person’s HIV risk, a better understanding of coital debut is needed. Data from a nationally representative survey that included 7,692 sexually active South African youth aged 15-24 were used to assess characteristics related to sexual debut and to respondents’ first sexual partner.