Accelerating HIV Prevention To Reduce Infections

Accelerating HIV Prevention To Reduce Infections: The Prevention 2020 Road Map provides the basis for a country-led movement to scale up HIV prevention programmes as part of Fast-Tracking a comprehensive response to meet global and national targets and commitments to end AIDS as a public health threat by 2030.

The Road Map was prepared through a consultative process that brought together more than 40 countries and organizations, including civil society organizations, networks of people living with HIV, faith-based organizations, networks of key populations and international organizations and foundations, to chart the way forward to achieving global HIV prevention goals by 2020.

Country assessments and national consultations were organized in participating countries towards reaffirming national leadership for HIV prevention, reviewing progress and discussing accelerated action for prevention.

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Thematic consultations and case study reviews were also conducted to develop key elements of the Road Map, most of which are also contained in a global results framework first proposed in a journal article in 2016 (Annex 1).

The Road Map is relevant for all low- and middle-income countries, but it focuses on 25 countries with high numbers of new infections in adolescents and adults in 2016 (referred to in this document as “coalition countries”). Exceptional international and national efforts are needed in these countries, which account for almost 75% of new adult HIV infections globally.

All countries, however, need to intensify HIV prevention efforts to meet commitments to end the AIDS epidemic. The focus of the Road Map is on HIV primary prevention and the promotion and provision of effective tools to prevent HIV infections.

It emphasizes the empowerment of adolescent girls, young women and key populations at risk so that they can protect themselves and stay free of infection. Primary prevention complements the preventive effects of treatment—they are mutually supportive. Primary prevention programmes are often the first entry point for individuals to HIV testing and treatment.

Community peer-led prevention programmes are also critical to reduce stigma and discrimination, which is key to the success of both prevention and treatment.

Meanwhile, expanded access to testing and treatment encourages people at risk to check their HIV status; this in turn provides the opportunity to retain people who test negative in ongoing prevention programmes.

Combination prevention packages all comprise a range of biomedical, behavioural and structural approaches, including testing and linkage to care, and efforts to address policy and human rights barriers.

Declines in new HIV infections remain too slow

Tremendous progress in the AIDS response over the past 15 years has inspired new commitments and targets. In 2016 United Nations Member States committed to reducing new HIV infections to fewer than 500 000 annually by 2020—a 75% reduction compared with 2010—and ending AIDS as a public health threat by 2030.

The United Nations General Assembly agreed in June 2016 that ending AIDS as a public health threat by 2030 requires a Fast-Track response, with three milestones to be reached by 2020:

  • Reduce new HIV infections to fewer than 500 000 globally.
  • Reduce AIDS-related deaths to fewer than 500 000 globally.
  • Eliminate HIV-related stigma and discrimination.

The remarkable scale-up of antiretroviral therapy has put the world on track to reach the target on AIDS-related deaths. Intensive efforts to eliminate new HIV infections among children and keep their mothers alive have achieved steep declines in the annual number of new infections among children.

Declines in new HIV infections have been too slow, however, and global HIV prevention targets are being missed by a wide margin, with 1.7 million new infections among adults still estimated to have occurred in 2016, a decline of only 11% since 2010.

Most reductions have occurred in high-prevalence countries in eastern and southern Africa, whereas new HIV infections in other regions have declined more modestly or even increased, as in eastern Europe and central Asia.

Trends in new infections among key populations globally have either stagnated (among sex workers) or increased (among people who inject drugs and men who have sex with men).

UNAIDS and partners are considering new metrics related to epidemic transition and progress toward the end of AIDS. These measurements will be included in global and country frameworks as they become operational. Read Full PDF Here