Going beyond “ABC” to include “GEM”: critical reflections on progress in the HIV/AIDS epidemic

HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute and Department of Psychiatry, Columbia University, New York, NY 10032, USA.
American Journal of Public Health (Impact Factor: 4.55). 02/2007; 97(1):13-8. DOI: 10.2105/AJPH.2005.074591
Source: PubMed


A considerable number of studies have sought to identify what factors accounted for substantial reductions in HIV seroprevalence after several countries deployed "ABC" (abstinence, be faithful, condom use) strategies. After much public discourse and research on ABC success stories, the Joint United Nations Programme on HIV/AIDS 2004 epidemic report indicated that nearly 50% of infected people worldwide were women, up from 35% in 1985. In light of the feminization of HIV/AIDS, we critically assess the limitations of ABC strategies. We provide 3 additional prevention strategies that focus on gender relations, economics, and migration (GEM) and can speak to the new face of the epidemic. Pressing beyond ABC, GEM strategies provide the basis for a stronger central platform from which national efforts against HIV/AIDS can proceed to reduce transmission risks.

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Available from: Shari L Dworkin, Dec 01, 2014
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    • "Reasons brought forward to explain these modest results are related to limitations in the content, implementation and delivery of educational programmes, to disabling environments and the complex cultural embeddedness of sexual behaviours, as well as to methodological problems in the studies conducted (kippax 2003; Michielsen et al. 2010; Vanwesenbeeck 2011). Overall, the field has been criticised for wrongfully breathing 'pan-optimism' (lesko 2010) and for the incorrect underlying assumption that individual decision-making is the key site of risk minimisation and progress towards sexual health (Bromnick and Swinburn 2003; Dworkin and Ehrhardt 2007). "
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    • "), there is a dire need to institute universal, comprehensive HIV-prevention strategies to avert new HIV infections. But HIV-prevention efforts in southern Africa, in particular, have been less than successful (Dworkin & Erhardt, 2007). "

    Full-text · Dataset · Nov 2012
    • "Gangakhedlkar et al. showed high prevalence of HIV infection among females in general population, who were previously considered as a low-risk group in India.(6) Recent surveillance data indicate that HIV epidemic is increasingly feminizing in India like in many other African countries.(7–9) Most Indian females acquire HIV from their husbands as 90% of infected women reported to be married and monogamous.(10–12) "
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