Putting prevention at the forefront of HIV/AIDS

The Lancet (Impact Factor: 45.22). 09/2008; 372(9637):421-2. DOI: 10.1016/S0140-6736(08)60882-X
Source: PubMed
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    • "The proficient and competent planning of effective customized HIV prevention programs and monitoring their impact relies on strong health information systems as well as good local and national surveillance. The exact mix of HIV prevention, treatment, care, support strategies, and structural interventions is determined by this data (Horton & Das, 2008). While several HIV prevention interventions appear promising with mathematical modelling providing further optism for the intervention, no single intervention is likely to be sufficient to prevent transmission of HIV on a global scale. "

    Full-text · Chapter · Oct 2011
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    • "HIV exceptionalism, the prioritisation of treatment over prevention, and the lack of attention to sexuality, sexual relations and, not in the least, women and young people, have brought us in an extremely awkward situation. At present, five new people are infected for every two individuals starting treatment, 40% of new infections concern young people and 60% of infected adults and 75% of infected young people in some parts of Africa are female (Bearinger et al. 2007, Horton and Das 2008). In the Asia Pacific region, 35% of all HIV infections are now in women compared to just 18% two decades ago. "
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    ABSTRACT: The acquired immune deficiency syndrome (AIDS) epidemic has given rise to multiple responses at multiple levels. In this article, a distinction is made between high-road and low-road solutions. High-road solutions typically address the disease and people as patients, focus on cure, treatment and pharmaceutical programmes, are noteworthy biomedical and technological, typically seen as ‘hard’ and top–down. Low-road solutions typically promote health and wellness among communities, focus on care, prevention and educational programmes, are often noteworthy rights based and holistic, typically seen as ‘soft’ and bottom–up. Whereas the sexual and reproductive health and rights movement characteristically takes the low road, human immunodeficiency virus (HIV)/AIDS programming seems to have drifted away from this broader agenda [Germain, A., Dixon-Mueller, R., and Sen, G., 2009. Back to basics: HIV/AIDS belongs with sexual and reproductive health. Bulletin of the World Health Organization, 87, 840–845] and to increasingly prefer the high road. This article critically reflects on those developments, understanding them within a context of conservative moralism, medicalisation of sexuality, neoliberal economics and corporate financial interests. The main argument is that the merits of high-road programming are many, but that it does not well provide for important structural solutions for the larger population, nor are larger development issues well served. The present advances in the direction of itinerary change and restoring the necessary balance with low-road programming are being considered.
    Full-text · Article · Sep 2011 · Critical Public Health
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    • "HIV prevention efforts with labor migrants have largely focused on disseminating information through education sessions, brochures, and counseling for those getting HIV tested (Organista et al., 2004). " Off-the-shelf slogans dreamt up by donors " (Horton & Das, 2008) have been critiqued, but country-specific empirically driven solutions are still wanting. Indeed, very few HIV prevention efforts for labor migrants have been empirically tested (Olshefsky, Zive, Scolari, & Zuniga, 2007; Organista et al., 2004). "
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    ABSTRACT: This study was a pilot investigation of the feasibility, acceptability, and effects of TRAIN (Transit to Russia AIDS Intervention with Newcomers) a three-session HIV preventive intervention for Tajik male labor migrants performed in transit. Sixty adult Tajik male labor migrants on the 5-day train ride from Dushanbe to Moscow were randomly assigned to either the intervention or a control condition. Each initially completed an in-person survey then another 3 days later (immediately postintervention), and participated in a cell phone survey three months later. All participants came to all intervention sessions, were satisfied with the program, and completed all postassessments. In comparison with the controls, the TRAIN group reported significant increases in condom use with sex workers and non-sex workers, condom knowledge, worry about HIV/AIDS, talking with persons about HIV/AIDS, talking with wife about HIV/AIDS, community activities, and religious activities. HIV/AIDS prevention performed in transit is feasible, accceptable, and potentially efficacious in diminishing HIV risk behaviors in labor migrants.
    Preview · Article · Jun 2011 · AIDS education and prevention: official publication of the International Society for AIDS Education
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