Governments Overlook Behavior Change in HIV Strategies, Experts Say at AIDS Conference

When formulating their HIV strategies, governments worldwide overlook research showing the importance of behavior change in HIV prevention, several experts said Tuesday at the XVII International AIDS Conference in Mexico City, the New York Times reports.

Experts discussed a variety of behavior modifications, including promoting safer sex practices, decreasing injection drug use, providing needle-exchange programs and promoting male circumcision. Although "none of the measures alone offer a simple solution to preventing infection with HIV," combining interventions and making their use more widespread is crucial to fighting HIV/AIDS, the experts said, the Times reports. They added that there is an increasing need to combine prevention and treatment efforts. Myron Cohen of University of North Carolina said researchers in the respective fields "need to get married," adding, "we need to be one community."

The Global HIV Prevention Working Group, a panel convened by the Bill & Melinda Gates Foundation and the Kaiser Family Foundation, on Tuesday released a report calling for a greater focus on behavior change. According to the Times, the report addressed misconceptions about behavior change interventions, including: "misplaced pessimism about the effectiveness of HIV prevention strategies," confusion between "the difficulty in changing human behavior" and the ability to accomplish that, and "misperception that because it is inherently difficult to measure prevention success, those efforts have no impact" (Altman, New York Times, 8/6).

Also on Tuesday, the Lancet released a series produced in collaboration with UNAIDS that examines how global efforts to control HIV/AIDS cannot succeed without a comprehensive prevention package. The series includes six papers -- which focus on combination prevention, decreasing the infectiousness of HIV-positive people, reducing risky behaviors, structural factors, targeting resources effectively, and the social and scientific movement needed to implement combination prevention -- as well as two commentaries (Lancet release, 8/5). In one of the articles, to be published Saturday, Thomas Coates of the University of California-Los Angeles, wrote, "Behavioral strategies need to become more sophisticated." He also called on governments to ensure that they have put in place "the right programs" to prevent HIV.

Jorge Saavedra, director of Mexico's HIV/AIDS program, said political leaders worldwide need to follow epidemiological and scientific evidence when planning HIV strategies and must involve more men who have sex with men in planning how to reach groups at high risk of HIV. Saavedra added that the world "will lose the fight against HIV" if governments do not follow the epidemiological and scientific evidence (New York Times, 8/6).

The Global HIV Prevention Working Group report is available online.

Kaisernetwork.org is the official webcaster of the XVII International AIDS Conference in Mexico City. Click here to sign up for your Daily Update e-mail during the conference. Related webcasts from Tuesday include:

• A plenary session featuring Saavedra and Cohen.
  
  
• A briefing to release the working group report.
  
  
• A briefing on the series from the Lancet.
  
  
• A video roundup featuring the day's highlights from the conference, with a focus on prevention.