Integrated prevention at the Alliance

A game of tag designed by Sports in Action, Zambia, to educate youth about HIV. © 2004 Gideon Mendel for International HIV/AIDS Alliance

With approximately five million new infections every year, and more than 40 million people living with HIV in 2004, comprehensive prevention work remains a cornerstone of HIV work. Prevention work at the Alliance is integrated with other issues such as care and treatment, voluntary counselling and testing, policy work, and civil society development, throughout both our prevention programming and our materials development.

The scale of the HIV epidemic requires a dramatic and long-lasting engagement from the international political community to provide an effective response, including comprehensive prevention to all. The new (and welcome) global effort to increase access to treatment also carries the potential risk of monopolising political debates and resources away from prevention work. So the Alliance is working to ensure that prevention stays at the forefront of the international political agenda and that HIV prevention and HIV-related treatment are seen as essential partners in the fight against HIV. The multiple causes of individual vulnerabilities to HIV must be addressed, with prevention programmes offering a comprehensive integrated approach, where individuals have the right to choose the prevention method that fits their needs, beliefs and situation.

The Alliance also works to inform and promote the design, implementation and support of programmes where prevention, care and support are approached as a continuum of care. Expanded access to treatment will certainly generate increasing requests for voluntary counselling and testing and, as more people know their status, an increased demand for prevention services, care and treatment. This means we must ensure the link between HIV prevention and voluntary counselling and testing services, develop prevention services in health care venues where anti-retroviral therapy is, or will be, provided, and target prevention services for people living with HIV.

Today, we have the largest generation of children and young people. We also have the highest number of children living with HIV. Effective prevention work with children could change the spread of the epidemic. The Alliance is working to ensure prevention work is an integral part of all our work with orphans and other vulnerable children.

Prevention programmes are effective only if designed, developed and implemented with the involvement of the communities concerned – making them better targeted and owned by their communities. This process also reinforces communities’ self respect, empowerment and social position (social capital), and in turn reduces vulnerability, which is a key factor to effective prevention. The Alliance works to build non-governmental organisations’ capacity to mobilise communities, assess, plan and implement HIV interventions together, and build social capital.

Finally, the Alliance is involved in ongoing evaluation of programmes to ensure their quality, and collaborates in implementing operational research that builds strong evidence of effective prevention strategies.