HIV prevention programmes need to be ‘fit for purpose’ by ensuring they are rights-based, evidence-informed and support people living with HIV to live longer and healthier lives. ‘Treatment as Prevention’ should become an integral part of the HIV response and efforts need to be scaled up to increase access to HIV testing, adherence counselling and treatment.
Rationale: Increasing the impact of prevention programmes is essential to preserve the long-term sustainability of treatment initiatives and prevent the epidemic from further undermining the gains made across the broader development agenda. ‘Traditional’ prevention programmes have mostly targeted those people who are HIV negative and have promoted a wide range of behaviour change strategies. While this is crucial, they have largely ignored both the needs and important role of people who are living with HIV. The ‘Positive Health Dignity and Prevention’ movement has highlighted the need to promote an approach that goes beyond health related services and includes other interventions to deal with issues of disclosure, sexuality, drug use, and laws – all within a human rights approach. Key approaches in a ‘positive prevention’ strategy include protecting their sexual and reproductive health and avoiding other sexually transmitted infections; delaying HIV disease progression; and promoting shared responsibility to protect their sexual health and reduce the risk of HIV transmission.
Current gaps to address:
- Promote positive prevention: PLHIV are a diverse group and have the right to live enjoyable and fulfilling sexual and reproductive health lives. Resources should be utilized to address the prevention needs of PLHIV and promote ‘treatment as prevention’ options.
- End the criminalization of HIV transmission: There are over 60 countries that have HIV-specific criminal laws. The criminalization of HIV transmission or exposure weakens HIV prevention efforts and marginalizes people who are already vulnerable to HIV infection. Awareness needs to be raised about issues relating to the criminalization of HIV transmission or exposure.
- Invest in evidence-informed programmes: The epidemic’s continued expansion stems from the frequent failure to apply proven prevention strategies tailored to the current realities of local epidemics, as well as the chronic and continuing underinvestment in evidence-informed prevention strategies. Funding needs to be increased for evidence-informed and rights-based prevention strategies that promote and support long-term social change to facilitate HIV prevention or that address the societal or structural factors that increase vulnerability.
Read all of IPPF's key messages for the 2011 UN High Level Meeting on AIDS in the June issue of the HIV Update newsletter: http://www.ippf.org/en/Resources/Newsletters/HIV+Update+Issue+26.htm