A Comment in this week’s edition of the Lancet argues that, despite substantial progress against AIDS worldwide, we are still losing ground, with new infections dwarfing numbers starting anti-retroviral therapy in developing countries. And while HIV incidence has fallen in Uganda, Kenya, and Zimbabwe, the generalised epidemic rages on. The Comment, coinciding with World AIDS day on December 1, is written by Dr James Shelton, Bureau for Global Health, US Agency for International Development, Washington, DC, USA. In it he discusses ten misconceptions which he believes impede HIV prevention.
Dr Shelton believes the focus must be on the key driver of generalised epidemics – concurrent partnerships – a risk that people do not fully appreciate, and the technical appreciation of which is only recent. However, he believes partner-limitation has been neglected as, among other things, it smacks of moralising and such mass behavioural change is alien to most medical professions.
He concludes: “Fortunately we can enhance partner limitation behaviour, akin to the behaviour change that many people have adopted spontaneously. State-of-the-art behaviour-change techniques, including explicit messages, that are sensitive to local cultures, can raise perception of personalised risk. Even modest reductions in concurrent partnerships could substantially dampen the epidemic dynamic. Other prevention approaches also have merit, but they can be much more effective in conjunction with partner-limitation. Now, more than 20 years into HIV prevention, we have to get it right.”
Notes to editors: Please see contents list for other HIV-related content in this week’s issue.
The paper associated with this release can be found at http://multimedia.thelancet.com/pdf/press/HIV.pdf
The Lancet