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What are the priority programmatic actions for different HIV epidemic scenarios?

Priority Programmatic Actions for Low-level Scenarios

  • Ensure high-quality coverage of HIV prevention, treatment and care services for most-at-risk populations.
  • Build capacity of the most-at-risk populations to organize, advocate and deliver prevention.
  • Strengthen services for prevention of mother-to-child-transmission, and for people living with HIV.
  • Provide training to law enforcement personnel to reduce harassment of most-at-risk populations.
  • Deal with stigma and discrimination, sexual violence, gender inequality, homophobia and human rights violations in broader public health campaigns.
  • Implement programmes with and for most-at-risk populations at sufficient scale and intensity
  • Promote livelihood alternatives to transactional sex.
  • Train service providers to work effectively with most-at-risk populations.
  • Provide diverse and evidence-informed sexuality and reproductive health education through the school curriculum.
  • Ensure adherence to blood safety standards.

Priority Programmatic Actions for Concentrated Scenarios

  • All actions outlined in low-level scenarios.
  • Provide and promote confidential voluntary HIV counselling and testing with referral to services; begin in high-risk settings.
  • Provide prevention and care programmes focused on mobile populations such as uniformed forces, clients of sex workers and most-at-risk young people.

Priority Programmatic Actions for Generalized Scenarios

  • All actions outlined in low-level and concentrated scenarios.
  • Provide and promote high quality HIV prevention, treatment, care for all key audiences and people living with HIV.
  • Build capacity for HIV prevention planning and implementation in governmental and nongovernmental organizations, and civil society.
  • Plan and implement a long-term (e.g. five years) national HIV communication programme to mobilize society and to create an enabling environment for prevention, treatment, care and support.
  • Intensify diverse and evidence-informed sexuality and reproductive health education for both in- and for out-of-school youth.
  • Ensure universal access to confidential HIV counselling and testing including provider-initiated counselling and testing,
  • Ensure universal and uninterrupted availability of male and female condoms.
  • Prioritize programmes for women and men that address risk behaviours and gender related vulnerability.
  • Promote the full range of prevention of mother to child transmission services.
  • Identify priority geographic settings where male circumcision is likely to have the greatest impact; progressively expand access to safe male circumcision services.
  • Promote joint HIV/TB services and positive prevention.
  • Partner with employers, employees and unions to promote HIV prevention and treatment at the workplace.
  • Ensure health care, law enforcement and social services employees are trained on HIV issues including gender and human rights.

Priority Programmatic Actions for Hyperendemic Scenarios

  • All actions outlined in low-level, concentrated and generalized scenarios.
  • Ensure well-informed, active and visible participation of leaders.
  • Strengthen pediatric prevention and treatment.
  • Ensure special programmes for orphans, street children and others at high risk, balancing needs for risk, vulnerability and impact reduction.
  • Promote male involvement in sexual and reproductive health programmes including HIV prevention, treatment of sexually transmitted infections, HIV counselling and testing, prevention of mother-to-child transmission services.