Coming to terms with complexity: a call to action for HIV prevention

Area of Science:

• Public Health
• Epidemiology
• Infectious Disease Control

Background:

• Over 25 years of AIDS responses have generated substantial knowledge on HIV transmission and prevention.
• Despite this knowledge, approximately 7000 new Human Immunodeficiency Virus (HIV) infections occur globally each day.
• Numerous local and national successes in controlling the epidemic exist, forming a robust evidence base.

Purpose of the Study:

• To discuss a combination of solutions needed to intensify HIV prevention efforts.
• To leverage existing evidence and lessons learned from past successes and failures in HIV prevention.
• To address the gap between knowledge and application in HIV prevention strategies.

Main Methods:

• Review of existing evidence on HIV transmission and prevention.
• Analysis of successful and unsuccessful HIV prevention programs and their implementation.
• Discussion of factors limiting the scale, quality, and impact of HIV prevention services.

Main Results:

• Successful HIV prevention approaches are not yet fully implemented or adequately funded.
• Existing programs often lack sufficient coverage, quality, and intensity.
• Few programs effectively address HIV vulnerability and the structural determinants driving the epidemic.

Conclusions:

• HIV prevention is complex but not insurmountable; a combination of solutions is necessary.
• Effective HIV prevention requires addressing issues of coverage, funding, and targeting interventions.
• Mobilizing a prevention constituency and providing confident leadership are crucial for overcoming barriers and intensifying HIV prevention.