General
The International Group on Analysis of Trends in HIV Prevalence andBehaviours in Young People in Countries most Affected by HIV
Trends in HIV prevalence and sexual behaviour among young people aged 15-24 years in countries most affected by HIV. 2010
In 2001, 189 member states signed the Declaration of Commitment at the United Nations General Assembly Special Session (UNGASS) on AIDS, and committed to achieving a 25% reduction in HIV prevalence among 15-24-year-old people in the 25 most affected countries by 2005 and globally by 2010 (UNGASS indicator number 22). This study assesses progress towards this UNGASS target and shows that seven countries demostrated a statistically significant decline of 25% or more in HIV prevalence among young ANC attendees by 2008, in rural or urban areas or in both: Botswana, Coˆte d’Ivoire, Ethiopia, Kenya, Malawi, Namibia and Zimbabwe. Three further countries showed a significant decline in HIV prevalence among young women (Zambia) or men (South Africa, Tanzania) in national surveys. Seven other countries are on track, whereas four are unlikely to reach the goal by 2010.
Football for an HIV-free generation Michel Sidibé, Kent Buse 2010 heralds the year set by the UN to achieve universal access to HIV prevention, treatment, care, and support. Despite major achievements and heroic eff orts over the past decades by people living with HIV to assert their rights for treatment equity, to end stigma and discrimination, and to ensure more inclusive approaches to governing the response, much remains to be done. 80 countries still criminalise homosexuality. People living with HIV face restrictions on entry, stay, and residence in some 57 countries About 10 million people are currently denied access to life-saving treatment. Regional Interagency HIV Prevention Working Group A Harrison, M L Newell, J Imrie, G Hoddinott. BMC Public Health 2010, 10:102 In South Africa, HIV prevalence among youth aged 15-24 is among the world's highest. Given the urgent need to identify effective HIV prevention approaches, this review assesses the evidence base for youth HIV prevention in South Africa. It ddresses study design, intervention design, including content and theoretical basis, thematic focus and HIV causal pathways, and intervention delivery and implementation, among youth aged 12-24 years in South Africa. S Gregson, E Gonese, T B Hallett, N Taruberekera, J W Hargrove, B Lopman, E L Corbett , R Dorrington, S Dube, K Dehne and O Mugurungi HIV prevalence fell in Zimbabwe over the past decade (national estimates: 29.3%, 1997 to 15.6%, 2007). National Census and survey estimates, vital registration data from Harare and Bulawayo, and prospective local population survey data from eastern Zimbabwe showed substantial rises in mortality during the 1990s levelling off after 2000. JHHESA The second National Communication Survey on HIV/AIDS 2009 (NCS 09) found that HIV/AIDS communication programmes in South Africa are successfully influencing people to have safer sexual relationships - and the more programmes to which people are exposed, the more they take heed. Overall, the country's HIV/AIDS communication programmes are working - and they are having a positive impact particularly with youth, on the levels of condom usage, HIV testing, and knowledge of the risks of having multiple sexual partners. Southern Africa Development Community As part of its commitment to HIV prevention, the SADC Secretariat HIV and AIDS Unit convened the SADC HIV Prevention Meeting: Achieving Prevention Targets on 7-9 June 2009 in Johannesburg, South Africa. This was three years after the SADC Expert Think Thank Meeting on HIV Prevention in High-Prevalence Countries in Southern Africa, Maseru, Lesotho, that identified key drivers of theepidemic and made recommendations for an intensified response. The June 2009 meeting discussed the degree of implementation of the key recommendations of the Maseru meeting and of the SADC HIV Prevention Strategy, reviewed the progress against UNGASS indicators and the SADC Epidemic Report, 2008, reviewed the successes, bottlenecks and the challenges experienced to date, and identified emerging evidence and issues and the highest priorities for HIV prevention in the coming period. East African Community A report from the first first EAC regional HIV Prevention Expert Think Tank and Multisectoral Stakeholders Meeting that was held in Nairobi from 24 - 26 February 2009. The meeting brought together more than sixty prevention experts including national AIDS authorities, international cooperating partners, researchers and civil society representatives to review the epidemics and responses in the Community and to make recommendations to parliamentarians for the way forward. Simon Gregson, Jim Todd, and Basia Żaba. Sex Transm Infect. 2009 April; 85(Suppl_1): i1-i2 This supplement presents 10 recent analyses of sexual behaviour data from longitudinal studies in five countries-Uganda, Tanzania, Malawi, Zimbabwe and South Africa-experiencing different sizes and stages of the HIV epidemic. Dunkle, K., et al. The Lancet (2008), Vol. 371 No. 9631, pp. 2183-2191 Most HIV transmission in sub-Saharan Africa is due to heterosexual transmission. The degree to which HIV transmission occurs within relationships is a critical question. The study estimates that 55.1 percent to 92.7 percent of new heterosexually acquired HIV infections among adults occurred within serodiscordant marital or cohabiting relationships. Applying a statistical model that took into account the higher rates of reported condom use in non-cohabiting partners, researchers estimated that from 60.3 percent to 94.2 percent of new heterosexually acquired infections occurred within marriage or cohabitation. Douglas Kirby, Daniel Halperin The evidence in this analysis supports the conclusion that the number of Ugandans who were sick with AIDS or died of the disease increased very rapidly during the late 1980s and early 1990s; that Ugandans' individual concerns about AIDS and their organized efforts to address AIDS also increased very rapidly, almost exponentially; and that Ugandans first became less likely to have sex before or outside of marriage or cohabiting relationships and began having fewer sexual partners in the late 1980s and early 1990s, and then in the early 1990s became more likely to use condoms during casual sex. This combination of less sex outside of long-term relationships (including less premarital sex), fewer sexual partners and greater condom use proved to be powerful. The reduction in sexual partners, including concurrent sexual partners, broke up sexual networks and the use of condoms decreased the chances of HIV transmission through these sexual networks. As a result, HIV incidence peaked in the late 1980s and then declined dramatically in the early 1990s. Finally, the evidence indicates that multiple factors led to these behavior changes in Uganda. UNAIDS UNAIDS This Call to Action was issued on behalf of all the authors and editors of The Lancet's special series on HIV prevention in 2008. The text appears in: Peter Piot, Michael Bartos, Heidi Larson, Debrework Zewdie, Purnima Mane. Coming to terms with complexity: a call to action for HIV prevention The Lancet, Volume 372, Issue 9641, Pages 845 - 859, 6 September 2008 UNAIDS P. Piot, M. Bartos, H. Larson, D. Zewdie, P. Mane This article discusses the combination of solutions which are needed to intensify HIV prevention, using the existing body of evidence and the lessons from our successes and failures in HIV prevention. MEMA kwa Vijana and Regai Dzive Shiri HelpAge International This document gives an insight into the why, what and how of HIV prevention with older people. Swaziland National Youth Council (SNYC) In 2004, Swaziland developed a National HIV and AIDS Communication Strategy, which takes into account the fact that HIV and AIDS issues are multi sectoral and therefore provides a coordinated framework for implementation of BCC programmes by various stakeholders. There is therefore need to assist stakeholders in developing an appropriate set of indicators for measuring processes, outcomes and impacts of BCC strategy targeting young people in Swaziland. For this to materialize and be effective, one has to establish benchmarks before intervention thus the need for the baseline survey conducted. UNAIDS Highlights the role of UNAIDS in intensifying HIV prevention and points to ways in which supportive action can be achieved jointly. UNAIDS SADC Dr. K. Kelly, CADRE and Mr. L. Maveneka WHO, UNFPA, IPPF, UNAIDS Highlights the linkages between sexual reproductive health and HIV prevention and proposes a set of key policy and program actions to strengthen linkages between SRH and HIV/AIDS programs. Chatterji, M., et al. Social Biology (2005), Vol. 52 No. 1-2, pp. 56-72 Twelve Demographic and Health Surveys from Sub-Saharan Africa were used in secondary data analysis to explore how transactional sex affects the risk of HIV/AIDS infection for young men and women. It was found that these young people more likely to engage in transactional sex compared to older people. Married youth were also less likely to engage in transactional sex compared to unmarried youth. Therefore, programs to reduce transactional relationships and/or to reduce the risk in these relationships should focus on young unmarried men and women.
Football for HIV prevention - report. 2010
This study presents the distinctive features, operational realities and future possibilities of football-based HIV prevention programmes from three perspectives: 1) implementation of these programmes; 2) the ways in which they use media, as well as the unique potential of the combination of football and media in HIV prevention efforts and 3) football as an effective platform for advocacy efforts.
Fomenting a prevention revolution for HIV. 2010
Last year, UNAIDS set nine priorities for the Joint Programme with high but achievable goals (panel). Seven of the goals focus on prevention, collectively underpinning my call for a "prevention revolution" -a revolution that recognises the heterogeneity of HIV epidemics, provides more targeted prevention for most-at-risk groups, and reverses the systematic under-investment in prevention interventions.
Review of HIV Prevention Context and Response with and for Young People in Eastern & Southern Africa (PowerPoint presentation). 2010
HIV prevention for South African youth: which interventions work? A systematic review of current evidence
HIV decline due to reductions in risky sex in Zimbabwe? Evidence from a comprehensive epidemiological review. 2008
These findings provide the first convincing evidence of an HIV decline accelerated by changes in sexual behaviour in a southern African country. However, in 2007, one in every seven adults in Zimbabwe was still infected with a life-threatening virus and mortality rates remained at crisis-levels
South Africa Second National Communication Survey on HIV/AIDS. 2009
Prevention meeting report: Achieveing prevention targets. 2009
First EAC regional HIV prevention experts think tank and multisectoral stakeholders meeting . 2009
Sexual behaviour change in countries with generalised HIV epidemics? Evidence from population-based cohort studies in sub-Saharan Africa
New heterosexually transmitted HIV infections in married cohabiting couples in urban zambia and rwanda: an analysis of survey and clinical data
Success in Uganda: an analysis of behavior changes that led to declines in HIV prevalence in the early 1990s. 2008
Combination prevention briefs. 2008
Modes of transmission
Male circumcision
Multiple concurrent partnerships
Women and girls
The Lancet, UNAIDS
Series on HIV prevention. 2008
The Lancet in conjunction with UNAIDS has produced a special series of six major articles on the future of global HIV prevention. The papers address the history of the global response to HIV, the evidence for biomedical interventions, how to improve behavioural approaches, addressing and understanding structural approaches, and how to make HIV prevention programmes work more effectively. They cite the successes and failures in HIV prevention to date, and conclude with a call to action for combination prevention to be implemented on a massive scale.
A call to action for HIV prevention. 2008
HIV Prevention: context. progress and challenges in ESA, October 2008 (Powerpoint presentation)
UNAIDS
HIV Prevention in ESA: where are we now and what more needs to be done? September 2008 (Powerpoint presentation, 2008)
Coming to term with a complexity: a call to action for HIV prevention. 2008
Rethinking how to prevent HIV in Young People: Evidence from two large randomised controlled trials in Tanzania and Zimbabwe. 2008
The MEMA kwa Vijana (Tanzania) and Regai Dzive Shiri (Zimbabwe) adolescent sexual and reproductive health intervention trials
focused on developing skills and changing attitudes and self-effi cacy to change behaviours. They used participatory, active learn-
ing methods, and included interventions in schools, health services and the broader community.Both interventions increased young people's knowledge, which is important in its own right. However they did not reduce HIV or other sexually transmitted infections.
HIV prevention strategies for older people, 2008
Baseline survey for BCC strategy for HIV and AIDS prevention among youth people aged 10-30 years in Swaziland. 2008
Intensifying HIV prevention. Policy position paper. 2005
UNAIDS action plan on intensifying HIV prevention, 2006- 2007. 2006
Report on the expert think tank meeting on HIV prevention in high prevalence countries in Southern Africa. 2006
The report of a meeting convened by the SADC Secretariat in May 2006, to analyze the evidence on the drivers of the epidemic in southern Africa, focusing specifically on the sexual transmission of HIV and to make recommendations to accelerate HIV prevention efforts. The meeting participants identified as the key drivers of the epidemic in southern Africa, multiple concurrent partnerships by men and women with low consistent condom use, and in the context of low levels of male circumcision. Representatives of National AIDS Councils, HIV prevention focal points, the UN, research institutions and NGOs attended the meeting.
Comprehensive review of behaviour change for preventing HIV transmission through sexual transmission in Zimbabwe. 2005
Sexual and reproductive health and AIDS: A framework for productive linkages. 2005
The factors influencting transactional sex among young men and women in 12 sub-Saharan African countries