2015 Fast-Tracking Combination Prevention
Analysis of evidentiary value
This report was issued by the Secretariat of the Joint Programme in the United Nations on HIV/AIDS (UNAIDS)–a coalition of 11 UN agencies and the World Bank helping to coordinate the global AIDS response by engaging with governments, civil society and people living with HIV.
UNAIDS is overseen by a Programme Coordinating Board composed of representatives from 22 geographically diverse countries; the 11 UN agencies, including the World Health Organization, UN Women, and the United Nations Population Fund; and five nongovernmental organisations. UNAIDS is the only UN entity that has representatives of civil society on its board.
This report explores how preventing HIV infection among people over 15 years of age is crucial to the global goal of eliminating AIDS.
Used as precedent
“Several HIV prevention methods have proved effective when used consistently, but no single prevention approach has the ability to stop the epidemic on its own. Combinations of prevention interventions are needed. Different settings and populations will require different combinations of interventions. The best HIV prevention impact comes from offering a package of interventions carefully selected to suit the epidemic setting and the population.” (p. 17)
“HIV prevention resources should be focused more intensely on geographic areas at elevated risk. Recent modelling found that in Kenya a uniformly distributed combination of prevention approaches could reduce new HIV infections by 40% over 15 years. But new infections could be reduced by another 14% if a prevention strategy with the same budgetary resources focused on people and locations of greatest risk. India has used geographical and population prioritization in its prevention efforts and, as a result, has seen a marked decrease in new infections between 2000 and 2010.” (p. 20)
“More than ever before, it is critical that national HIV prevention responses focus on combinations of these proven high-impact tools, including condoms, VMMC, PrEP and ART. Context-specific, evidence-based behavioural and structural programme elements are important as well. Approaches providing basic knowledge, awareness and general behaviour change messages need to be replaced with approaches informed by local evidence on factors shaping behaviours and programme models, which have been effective in achieving the intended outcomes in similar contexts.” (p. 20)