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AIDS: Global Initiative Needed to Prevent HIV Infections

The Lancet recommends combination of strategies including male condoms and circumcision

WEDNESDAY, Aug. 6 (HealthDay News) -- To combat the worldwide HIV/AIDS epidemic, comprehensive prevention strategies are urgently needed, according to a series of six articles published online Aug. 6 in The Lancet and presented this week at AIDS 2008, the International AIDS Conference held in Mexico City.

In one study, Michael H. Merson, M.D., of Duke University in Durham, N.C., and colleagues reviewed the history of the HIV/AIDS pandemic and faulted global prevention efforts as woefully inadequate. They found that less than 10 percent of at-risk individuals worldwide are receiving key prevention services, and estimated that expanded services could prevent more than half of HIV infections expected to occur by the year 2015 and reduce treatment costs by $24 billion. In sub-Saharan Africa alone, they found that 70 percent coverage of male circumcision services could prevent about 700,000 HIV infections.

In a second study, Nancy Padian, Ph.D., of the Women's Global Health Imperative, RTI International in San Francisco, and colleagues argued for a combination approach that reduces the infectiveness of HIV-positive individuals with proven strategies such as male condoms, male circumcision and prophylactic antiretroviral drugs to prevent mother-to-child transmission. They also emphasized the importance of treating other sexually transmitted infections that increase the risk of HIV transmission and providing contraceptives to HIV-positive women who do not wish to become pregnant.

In a third study, Peter Piot, Ph.D., of the Joint United Nations Programme on HIV/AIDS in Geneva, Switzerland, and colleagues called for a massive social movement that mobilizes people in workplaces, schools, communities and places of worship, and a massive expansion of operational research to determine optimal prevention strategies, develop an effective HIV vaccine, and identify other potential HIV prevention technologies.

"We must have the courage to press ahead, because if we fail the challenge of HIV prevention, HIV/AIDS will relentlessly undermine human progress," Piot and colleagues conclude. "An energized HIV prevention movement, marching hand-in-hand with the movement to make access to treatment universal, is a goal truly worth the effort it will take."

Abstract - Merson
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Abstract - Padian
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Abstract - Piot
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