Reconsidering primary prevention: Call to action for the global HIV response
The world needs a new phase in the evolution of the HIV response – one that reinvigorates prevention by seamlessly combining the strategic efficacy of upstream, midstream, and downstream interventions with the powerful effectiveness of community action.
Community-led prevention must be properly resourced. Policy makers and donors, including governments, must shed their reluctance to openly and positively address sex and drug use in their public health discourse and responses to HIV. The international development and HIV sectors must adopt a more nuanced understanding of gender. And we must collectively embrace the fact that even the best prevention tools, including antiretroviral medications, will not work without assent from communities most impacted by HIV.
The Global Forum on MSM & HIV (MSMGF), Global Action for Trans Equality (GATE), IRGT – A Global Network of Transgender Women and HIV, The Global Advocacy Platform to Fast-track the HIV and Human Rights Responses with Gay and Bisexual Men (The Platform), the Global Network of People Living with HIV (GNP+), the Global Network of Sex Work Projects (NSWP), the International Community of Women Living with HIV (ICW), and the International Network of People Who Use Drugs (INPUD) are unified in calling upon advocates, healthcare providers, researchers, public health officials, and donors to:
- Stop chasing magic bullet solutions to HIV and end sloganeering about HIV drug coverage – instead, invest in carefully tailored combination approaches;
- Evolve primary prevention in a manner that seamlessly stitches together bio-medical, behavioral, community, and structural interventions, because these interventions lose their effectiveness without the others;
- Combine and tailor prevention approaches with consideration to acquisition and transmission dynamics that are specific to key populations – blanket approaches leave people behind;
- Imbue HIV primary prevention, care, and treatment with the power of community ownership and abandon top-down approaches;
- Remedy funding inequities by investing more substantively, strategically, and differentially in evidence-informed, rights-based, and community-led programs; and,
- Adopt community-endorsed, human rights-based principles of practice, starting with the GIPA principle.
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