Prevention

The Declaration of Commitment spotlights prevention as the mainstay of a global response to HIV/AIDS, and as part of an integrated response that also includes care and treatment(1).  Member States unanimously committed to implement prevention programmes proven to be effective.  As efforts to expand access to life-saving treatments accelerate, success in prevention is essential to make sure those programmes can be sustained for those already infected.

Member States of UNGASS declared that to stop the spread of the epidemic, countries must emphasize prevention in education, nutrition, information and health-care services(2).  Care, support and treatment contribute to prevention through voluntary and confidential HIV testing, and by providing vulnerable people and those living with HIV/AIDS with health-care services, information and preventive supplies(3).   Respect for diversity of culture, family, ethics and religion are important factors in prevention, and must be viewed within a human rights context(4).   Further, there are negative economic, social, cultural, political, financial and legal factors that hamper prevention efforts and must addressed(5).

Fortunately, Member States are armed with the knowledge about what works to prevent HIV transmission.  To curb infection, they agreed to communicate life-saving information, forge new social norms, promote the benefits of condoms and new prevention mechanisms, and empower people to protect themselves from infection. These efforts include traditionally disenfranchised groups such as migrants and mobile workers, and envision strengthening the response to HIV/AIDS in the world of work.  Together, these responses combat stigma and can reduce the root causes that contribute to infection. 

Importantly, the Declaration of Commitment recognizes that in all countries with successful prevention programs, there exists the vocal and sustained support of national political leaders.

Governments committed themselves to:

• Challenge gender inequalities in relation to HIV/AIDS and encourage the involvement of men and boys in HIV-prevention programmes(6).  
• By 2003, implement universal precautions in health-care settings to prevent transmission of HIV(7).
• By 2003, reduce HIV incidence among groups with high rates of infection or a high risk of infection(8).  
• By 2005, implement prevention and care programmes in the workplace (public, private and informal)(9)  and for migrant and mobile workers, including provision of information on health and social services(10). 
• By 2005, ensure a wide range of prevention programmes in all countries that are culturally sensitive and available in local languages; reduce risky behaviour; encourage responsible sexual behaviour; reduce harm related to drug use; expand access to male and female condoms, clean injecting equipment, safe blood supplies, treatment for sexually transmitted infections, and voluntary and confidential counselling and testing(11).  
• By 2005, ensure that 90%, and, by 2010, 95% of youth aged 15–24 have information, education, services and life-skills that enable them to reduce their vulnerability to HIV infection(12).  
• By 2005, reduce HIV prevalence among young people (aged 15 to 24) by 25% in the most affected countries, and by 2010, reduce it by 25% globally.
• By 2005, reduce by 20% and, by 2010, by 50%, the number of babies infected by HIV by ensuring that: 80% of pregnant women in antenatal care receive HIV information, counselling and other prevention services; HIV-infected women and babies receive treatment to reduce mother-to-child transmission; and HIV-infected women receive treatment, including antiretroviral drugs and breast-milk substitutes(13).

Footnote

(1) Paragraph 17, Declaration of Commitment

(2) Paragraph 18.

(3) Paragraph 19.

(4) Paragraph 20.

(5) Paragraph 21.

(6) Paragraph 47.

(7) Paragraph 51.

(8) Paragraph 48.

(9) Paragraph 49.

(10) Paragraph 50.

(11) Paragraph 52.

(12) Paragraph 53.

(13) Paragraph 54.