Saturday, June 6, 2009

UNAIDS and World Bank Release Report Detailing an Interconnectedness Between Prevention Efforts and Transmission

A recently released report from UNAIDS and the World Bank finds that national HIV prevention strategies are not reaching at risk groups in at least 5 African Countries. The study was conducted from 2007 to 2008 and focused on determining where most HIV cases were occurring in each country, and whether these statistics were a result of inadequate prevention programs or under-funding issues.

If national HIV prevention strategies are to succeed, countries must first understand the character and drivers of their epidemic and focus on effective interventions. Kenya, Lesotho, Mozambique, Swaziland and Uganda were all determined to have inadequate HIV prevention strategies, and the report determined that this was in large part due to the failure of prevention initiatives to address the most common forms of transmission. For example, in Lesotho most new infections occur because of concurrent sexual relationships, both before and after marriage, but the prevention efforts in this country tend to focus on unsafe sex with multiple partners instead of prevention methods for those in long term monogamous relationships. Mozambique presents another example of the interconnectedness between prevention and transmission of the disease. An estimated 19% of new HIV infections are transmitted as a result of commercial sex work, but Mozambique has very few programs that target the specific category of sex workers.

In the wake of the current financial crisis, many African countries' budgets have been drastically reduced, and essential programs have been cut. In many of the surveyed countries, spending on HIV prevention has dropped, leading countries to concentrate their efforts on general prevention, instead of targeting specific at risk groups. In Lesotho, only 13% of the national HIV/AIDS budget is spent on prevention, and these efforts may not even be completely effective. Even though budget spending is being cut, an emphasis must be placed on prevention programs in order to address the problem from the beginning. If prevention efforts are stepped up, the country will have to deal with fewer cases, which means less funding for medical treatments and other problems associated with high infection rates in society. There is often a mismatch between HIV prevention efforts and the actual factors driving new infections, which can lead to significant resources being invested in programmes of limited effect. In order to reach those most at risk, spending must be focused on effective spending efforts.

The report also provided recommendations for those countries surveyed on how to better implement evidence-based prevention efforts. Based on collective evidence, the report determined that Lesotho should revise its prevention messages to address multiple concurrent partnerships and integrate the subject into future initiatives, and Mozambique should focus condom promotion on groups such as sex workers.

To read other country specific recommendations, you can access the report in its entirety at:

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