期刊
LANCET
卷 372, 期 9639, 页码 669-684出版社
ELSEVIER SCIENCE INC
DOI: 10.1016/S0140-6736(08)60886-7
关键词
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资金
- The Ford Foundation
- UCLA Center-for HIV Identification, Treatment, and Prevention Services
- National Institute of Mental Health [2P30MH058107, P30MH43520]
- The Diana, Princess of Wales Memorial Fund
- The Franklin Mint Foundation
- The MAC AIDS Fund
- The UCLA AIDS Institute
- UCLA Center for AIDS Research
- The National Institute of Allergy and Infectious Diseases [A128697]
- The John M Lloyd Foundation
- Columbia Center for HIV Clinical and Behavioral Studies
- HIV Prevention Trials Network (HPTN)
- National Institute of Allergy and Infectious Diseases
- National Institute of Child Health and Human Development
- National Institute on Drug Abuse
- Office of AIDS Research, of the National Institutes of Health
- US Department of Health and Human Services
- Family Health International
- Fred Hutchinson Cancer Research Center
- Johns Hopkins University
- University of Pennsylvania
This paper makes five key points. First is that the aggregate effect of radical and sustained behavioural changes in a sufficient number of individuals potentially at risk is needed for successful reductions in HIV transmission. Second, combination prevention is essential since HIV prevention is neither simple nor simplistic. Reductions in HIV transmission need widespread and sustained efforts, and a mix of communication channels to disseminate messages to motivate people to engage in a range of options to reduce risk. Third, prevention programmes can do better. The effect of behavioural strategies could be increased by aiming for many goals (eg, delay in onset of first intercourse, reduction in number of sexual partners, increases in condom use, etc) that are achieved by use of multilevel approaches (eg, couples, families, social and sexual networks, institutions, and entire communities) with populations both uninfected and infected with HIV. Fourth, prevention science can do better. Interventions derived from behavioural science have a role in overall HIV-prevention efforts, but they are insufficient when used by themselves to produce substantial and lasting reductions in HIV transmission between individuals or in entire communities. Fifth, we need to get the simple things right. The fundamentals of HIV prevention need to be agreed upon, funded, implemented, measured, and achieved. That, presently, is not the case.
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