HIV Prevention Needs an Integrated Approach
MEXICO CITY (Reuters Health) Aug 06 - A unified behavioral, biomedical and structural approach is needed to check the spread of the HIV epidemic, according to researchers speaking at the Lancet special symposium on HIV prevention, held during the International AIDS Conference here.
The Lancet has published a series of articles on HIV prevention. During a press conference, Jeffrey O’Malley from the UN Development Program and co-author of the first article, said, “The decade of the 1990s was a lost opportunity because of lack of involvement and funding.”
“Global prevention efforts remain woefully insufficient,” the researchers say in an accompanying press release. “An urgent and revitalised global movement” that utilizes a combination approach is the need of the hour, they conclude.
“With no HIV vaccine available for the foreseeable future, focus must be on proven biomedical HIV prevention methods,” the second speaker, Dr. Nancy Padian from the Women’s Global Health Imperative, San Francisco and her team recommend in the press release.
Use of male condoms, male circumcision, mother-child transmission prophylaxis, pre-exposure prophylaxis with oral and topical antiretrovirals, and treatment of sexually transmitted infections are some of the promising options, they note. “There is no single magic bullet,” Dr. Padian said.
“Risky behaviors must change,” added Professor Thomas Coates from UCLA. Success stories in HIV have been primarily through behavior change, he pointed out. A combination of behavioral strategies including fewer sexual partners, delaying first sexual intercourse, protected sex, and avoidance of injectable and other drug use are some that can have an impact, Dr. Coates and his team mention in the press release. A “radical commitment” is needed, he concluded.
Structural approaches “represent a largely untapped, yet crucial, part of combination HIV prevention,” Dr. Geeta Rao Gupta from the International Center for Research on Women, Washington and her colleague write in the press release. These factors complement the benefits of behavioral interventions, they add.
Empowerment of sex workers and measures against gender inequality are some of the interventions that have produced encouraging results, co-author Dr. Jessica Ogden said during the press conference, mentioning the success of the Sonagachi project in reducing HIV prevalence five-fold in Kolkata, India.
Dr. Marie Laga from the Institute of Tropical Medicine, Antwerp, Belgium, one of the co-authors of the fifth article, recommends improvements in targeting high risk populations, selecting and delivering the correct preventive interventions, monitoring, and optimal funding.
Effective HIV prevention can reduce the incidence of new infections by two-thirds by the year 2015, Dr. Peter Piot, Director of UNAIDS and his team write in the concluding article.
Sustained political leadership and strengthening of health systems are needed, Dr. Piot said in the press conference.
“We need to pursue every possible avenue we have to prevent HIV and AIDS,” Jeffrey O’Malley told Reuters Health.
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