HIV/AIDS Prevention Programs
Well-targeted, comprehensive prevention efforts can significantly reduce HIV transmission, and is therefore a strong priority in the global fight against the HIV/AIDS pandemic. The President’s Emergency Plan for AIDS Relief seeks to prevent at least seven million new infections by 2008, and the U.S. Agency for International Development is contributing its expertise to the success of this initiative.
What is USAID’s approach to HIV prevention?
ABC: abstinence, be faithful, use condoms—USAID has carried out pioneering studies in the area of behavior change for successful HIV prevention, often referred to as the “ABCs.” This approach was made famous for its success in Uganda, and new studies are being planned to optimize the implementation of ABC interventions for youth and other at-risk groups. USAID seeks to further the development of a more comprehensive and effective, evidence-based approach to behavior change programming.
Changing high-risk sexual behavior—USAID has been a leader in developing, implementing, and monitoring communication strategies to change high-risk behavior such as having multiple sexual partners and unprotected sex. USAID activities develop appropriate messages to reach groups at high risk as well as the general population. Through a combination of interpersonal and mass media, including newspapers, radio, billboards, peer counseling, and community theater, USAID communications campaigns encourage changes in behavior and help reduce stigma surrounding HIV/AIDS. The agency has strengthened its commitment to a central fund for condom procurement.
Preventing mother-to-child transmission of HIV—USAID is helping women infected with HIV reduce the likelihood of transmitting the virus to their children by supporting improvement of antenatal care, short-course antiretroviral medication, strengthened family planning and safe delivery services, counseling and support for safer infant feeding, and voluntary counseling and testing. USAID sponsors MTCT programs in 26 countries.
Promoting voluntary counseling and testing—Voluntary counseling and testing provides an important opportunity for prevention and care. It can help reduce risky behaviors among both infected and uninfected individuals and brings infected individuals in contact with care and support services. USAID activities have developed refinements to increase the reach and effectiveness of VCT, established testing centers, trained counselors, and supported community outreach workers to promote the use of counseling and testing services. USAID supports counseling and testing in 22 countries and one regional program.
Treating sexually transmitted infections—Research has found that the presence of other sexually transmitted infections increases the likelihood of acquiring HIV. Efforts, however, can be hindered by social stigma directed at persons with sexually transmitted infections, lack of resources, and weak health infrastructure. USAID has developed a number of innovative strategies to overcome these obstacles and is developing programs that utilize appropriate strategies for particular settings and populations.
How have USAID’s programs contributed to successful HIV prevention?
Uganda—With strong leadership and aggressive prevention and care interventions, Uganda reduced its national HIV prevalence from over 15 percent in the early 1990s to only 5 percent at the end of 2001. USAID contributed to this success by supporting local faith-based prevention programs, community and workplace HIV/AIDS education programs, voluntary counseling and testing, peer educator training, and support for orphans.
Thailand—Thailand slowed its growing HIV epidemic by requiring 100 percent condom use in brothels. As a result of this policy and an accompanying public information campaign, condom use increased to more than 90 percent among sex workers, visits by men to sex workers decreased by over half, and HIV infection rates among military recruits were cut in half. USAID has contributed to this success by supporting behavior change programs, condom promotion and distribution, and cross-border prevention activities.
Zambia— There was apparently a reduction in HIV prevalence among urban youth during the 1990s in Zambia, where there has been a high level of reported behavior change. USAID has supported a mass media campaign targeted at young adults, which uses messages such as “abstinence is cool,” that has contributed to such behavior changes as increased abstinence and monogamy, lower number of sexual partners, and more consistent condom use.
Dominican Republic—HIV prevalence also appears to have stabilized or declined in the Dominican Republic. Condom use during commercial sex has increased, and men are reporting fewer sexual partners. USAID supports workplace peer education, youth outreach, strengthening of treatment services for sexually transmitted infections, and promotion of behavior change among commercial sex workers and men who have sex with men.
Cambodia—Cambodia has succeeded in reducing HIV prevalence through a large reduction in visits to sex workers and increased condom use. USAID helped to establish a nation-wide condom distribution program and a highly effective public information campaign.
Senegal— Hailed as a model for Africa, Senegal has successfully stabilized its national infection rate at below one percent since 1997. The program incorporates a dual focus on covering high-risk settings as well as involvement of religious leaders/faith-based organizations in reinforcing traditional values around sexual norms. USAID has contributed to this success through targeted condom distribution, along with supporting abstinence and partner reduction approaches for the general population and youth specifically.
Ethiopia—HIV prevalence has been dropping among young women in the capital, Addis Ababa, and in a recent workplace study men reported very large reductions in commercial and other casual sex. USAID supports community prevention efforts by the Ethiopian Orthodox Church and other local organizations actively involved in prevention work.
March 2004
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