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What are the essential policy actions for HIV prevention?


Two decades of experience demonstrate the value of a comprehensive and sustained approach to HIV prevention, informed by country-level experience and evidence. These have been summarized in Essential Policy Actions for HIV Prevention.

  1. Ensure that human rights are promoted, protected and respected and that measures are taken to eliminate discrimination and combat stigma.
  2. Build and maintain leadership from all sections of society, including governments, affected communities, nongovernmental organizations, faith-based organizations, the education sector, media, the private sector and trade unions.
  3. Involve people living with HIV, in the design, implementation and evaluation of prevention strategies, addressing the distinct prevention needs.
  4. Address cultural norms and beliefs, recognizing both the key role they may play in supporting prevention efforts and the potential they have to fuel HIV transmission.
  5. Promote gender equality and address gender norms and relations to reduce the vulnerability of women and girls, involving men and boys in this effort.
  6. Promote widespread knowledge and awareness of how HIV is transmitted and how infection can be averted.
  7. Promote the links between HIV prevention and sexual and reproductive health.
  8. Support the mobilization of community-based responses throughout the continuum of prevention, care and treatment.
  9. Promote programmes targeted at HIV prevention needs of key affected groups and populations.
  10. Mobilizing and strengthening financial, and human and institutional capacity across all sectors, particularly in health and education.
  11. Review and reform legal frameworks to remove barriers to effective, evidence based HIV prevention, combat stigma and discrimination and protect the rights of people living with HIV or vulnerable or at risk to HIV.
  12. Ensure that sufficient investments are made in the research and development of, and advocacy for, new prevention technologies.

Prioritizing policy actions depends on the epidemic and local context. Some measures are repeated in all scenarios, whereas others are additional or modified from one scenario to another. Prioritizing policy actions is useful for both planning and evaluating existing programmes.


Priority policy actions
Low
  • Provide a clear mandate for leadership, resource mobilization, coordination and reporting to the National AIDS Authority.
  • Develop a costed plan for effective HIV prevention programmes.
  • Commit sufficient resources to HIV prevention, track and analyse expenditures, and build in accountability procedures.
  • Amend legislation and policies that create or enforce barriers to HIV prevention.
  • Enforce laws against child marriage, sexual abuse and gender-based violence.
  • Review user fees or taxes on key commodities such as condoms.
  • Review every sector for practices that facilitate risk behaviour.
  • Review, amend and enact appropriate laws and policies and enforce anti-discrimination legislation.
Concentrated
  • All actions outlined in low-level scenarios.
  • Train and support leaders (political, networks of people living with HIV and vulnerable communities, private sector, faith-based) to support prevention, speak out against HIV-related stigma and discrimination, and to support human rights, including gender equality and universal access.
Generalized
  • All actions outlined in low-level and concentrated scenarios.
  • Conduct a high-profile review of every sector to establish that current practices do not hamper access to HIV prevention services.
  • Advocate for elimination of fees or taxes that increase cost of commodities or services.
  • Promote and energize multisectoral linkages with government ministries that need to be involved in the AIDS response (e.g. local development, human resources, and uniformed services) and establish clear sectoral responsibilities for risk reduction.
  • Promote male circumcision as part of comprehensive HIV prevention programming.
  • Identify government departments or sectors that can reduce risk situations (e.g. reduce spousal separation, improve prisoner welfare etc.).
Hyperendemic
  • All actions outlined in low-level, concentrated and generalized scenarios.
  • Build public awareness and demand for changes in legislation that hinder prevention, such as laws that discriminate against women and girls.
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