YOU ARE HERE:
The importance of prevention
| Last updated: 17.05.02 |
Prevention must be central to the global response to AIDS
To download this policy statement as a PDF file, click here.
The International HIV/AIDS Alliance works with communities in developing countries to prevent the spread of HIV, support and care for those infected and ease the impact of HIV on families and communities. While prevention, care and impact alleviation are all essential and all inter-linked, there can be no debate that prevention of new HIV infections is always preferable to having to manage the
consequences of the AIDS epidemic.
Since its establishment in 1993, the Alliance has provided both financial and technical support to over 1,500 HIV/AIDS projects and has worked with NGOs and CBOs from over 40 countries. This experience reveals that:
circle whereby new generations become increasingly vulnerable.
reformed, in particular laws that disinherit women and children, marginalise sex workers and men who have sex with men, or prohibit the distribution of safe needles and syringes. Cultural practices that reinforce discrimination or facilitate transmission must be changed, but it should be recognised that some cultural practices can also reinforce prevention messages. Most importantly, leaders must create hope for the future.
The crux of effective prevention, however, lies with individuals and communities:
equipment.
social marketing have a role in demand-generation, but need to be supplemented by community mobilisation, interactive activities such as peer education, skills building in sexual negotiation and condom use, and individual and group counselling.
The Alliance believes that the United Nations and its Member States should:
The Alliance’s contribution is and will continue to be:
"Before I was a shy person and didn't like to talk in case I said anything wrong. Working with Despertando I learned about my own sexuality and sexual health. I learned about my body and about being a woman, as well as about issues such as HIV/AIDS. I learned that I have rights as a woman and as a memberof my community…I had my own ideas and thoughts, but I never said them out loud. Now I've learned what it is to be a woman as well as a wife and a mother…Now I have the confidence to know what I want and to speak out." Elsa Almendaris describing the benefits of the HIV prevention strategy of Despertando, an NGO supported by Kimirina, the Alliance linking organisation in Ecuador.
The International HIV/AIDS Alliance
mailto:mail@aidsalliance.org
www.aidsalliance.org
www.aidsmap.com
May 2001
To download this policy statement as a PDF file, click here.
The International HIV/AIDS Alliance works with communities in developing countries to prevent the spread of HIV, support and care for those infected and ease the impact of HIV on families and communities. While prevention, care and impact alleviation are all essential and all inter-linked, there can be no debate that prevention of new HIV infections is always preferable to having to manage the
consequences of the AIDS epidemic.
Since its establishment in 1993, the Alliance has provided both financial and technical support to over 1,500 HIV/AIDS projects and has worked with NGOs and CBOs from over 40 countries. This experience reveals that:
- Broad social, economic and epidemiological factors are more important than anything else in determining the spread of HIV. Factors that fuel vulnerability include gender inequalities and the oppression of girls and women, severe income inequality and poverty, human rights abuses, stigma around both HIV and sexuality, and the marginalisation of behaviours such as sex for money, sex between men and injecting drug use. The impact of AIDS itself creates a vicious
circle whereby new generations become increasingly vulnerable.
- It is easier for a rich country with relatively little income disparity to control the spread of HIV than it is for a poor country. Nevertheless, it is possible to slow or reverse the spread of HIV in poor countries, and essential to avoid exacerbating poverty.
- Political leadership is more than just speaking out about AIDS. Leaders need to encourage acceptance and social inclusion of people with HIV and those who are most vulnerable, take steps to support people to talk openly about sexuality, including sexuality of young people and sexual minorities, ensure appropriate attention to AIDS in the school system, and allocate resources to the fight against AIDS. Laws and practices that are a barrier to effective prevention must be
reformed, in particular laws that disinherit women and children, marginalise sex workers and men who have sex with men, or prohibit the distribution of safe needles and syringes. Cultural practices that reinforce discrimination or facilitate transmission must be changed, but it should be recognised that some cultural practices can also reinforce prevention messages. Most importantly, leaders must create hope for the future.
- NGOs and CBOs have a crucial role in advocating for political and social leadership, and in creating a political space to make such leadership possible.
The crux of effective prevention, however, lies with individuals and communities:
- Often, communities respond spontaneously to the threat of HIV or the impact of AIDS. When they do not, NGOs and CBOs can use participation and facilitation techniques to generate such responses. This is particularly important with people already affected by HIV/AIDS, and populations key to epidemic dynamics, especially young people becoming sexually active, people with multiple sexual partners, men who have sex with men and people who share drug injecting
equipment.
- The first step in effective prevention is to create individual and community demand. People need to know how to slow the spread of HIV, and they also need to be encouraged and supported to adopt or maintain safer behaviour, to seek sexual health services, including treatment of sexually transmitted infections, and to acquire and use male or female condoms. Awareness-raising and
social marketing have a role in demand-generation, but need to be supplemented by community mobilisation, interactive activities such as peer education, skills building in sexual negotiation and condom use, and individual and group counselling.
- Demand needs to be complemented by an affordable and accessible supply of services and commodities. This includes male and female condom provision, STI diagnosis and treatment,provision of clean needles and syringes, and voluntary counselling and testing. Special attention must be paid to ensure that these services and commodities are available and appropriate for the most vulnerable, including young people.
- Finally, individual and community action on AIDS is essential to improve social conditions and to reduce overall vulnerability to HIV: working from families to villages, to neighbourhoods, to countries in order to challenge stigma and discrimination, empower women and marginalised communities, and create hope for the future.
The Alliance believes that the United Nations and its Member States should:
- Make explicit calls for political leaders to allocate domestic resources to comprehensive HIV prevention strategies, ensure that HIV/AIDS is addressed in national education policy and practice, reform laws and regulations which exacerbate vulnerability to HIV, and promote social inclusion and involvement of people with HIV and people key to epidemic dynamics.
- Ensure that prevention strategies are strongly linked to AIDS care and impact alleviation strategies.
- Accelerate efforts to prevent mother-to-child transmission.
- Call for national prevention programmes that combine focused support to populations key to epidemic dynamics, with broader efforts that build awareness, enhance the status of women, reduce stigma, reach new generations of sexually active young people, and identify and refer vulnerable people to services.
- Call for prevention strategies to include demand-generation and not just supply of services and commodities.
- Call for and support broad community mobilisation efforts in response to AIDS, including action to build social cohesion and hope and to reduce overall vulnerability.
- Recognise that prevention is still the most important priority in countries heavily affected by AIDS,both because the majority of people in all countries are HIV negative, and in order to reach new generations of sexually active young people.
- Recognise that prevention is equally important in countries not yet heavily affected by AIDS, where focused action on HIV now can prevent future AIDS epidemics from emerging.
The Alliance’s contribution is and will continue to be:
- To support NGOs, CBOs and affected communities to advocate for more attention to HIV/AIDS, in particular for countries on the frontiers of the epidemic, and with populations key to epidemic dynamics.
- To work with NGOs and CBOs in particular countries to support, enhance and expand community level HIV prevention efforts, with strong links to AIDS care and impact alleviation.
- To advocate for comprehensive and balanced prevention efforts, including through the promotion of linkages, referral systems and partnerships among institutions.
"Before I was a shy person and didn't like to talk in case I said anything wrong. Working with Despertando I learned about my own sexuality and sexual health. I learned about my body and about being a woman, as well as about issues such as HIV/AIDS. I learned that I have rights as a woman and as a memberof my community…I had my own ideas and thoughts, but I never said them out loud. Now I've learned what it is to be a woman as well as a wife and a mother…Now I have the confidence to know what I want and to speak out." Elsa Almendaris describing the benefits of the HIV prevention strategy of Despertando, an NGO supported by Kimirina, the Alliance linking organisation in Ecuador.
The International HIV/AIDS Alliance
mailto:mail@aidsalliance.org
www.aidsalliance.org
www.aidsmap.com
May 2001