HIV Combination Prevention: Ingredients & Recipes for a success
By contrast, approaches that could have a higher impact have a lower or unknown effectiveness, because they have not been tested or because they are poorly and badly implemented, if at all (consider sex education at school, or human rights for men-who have sex with men).
This points to a critical aspect of Combination Prevention which is that combining different prevention approaches will not be enough if they all rely on the same “mechanics” and share the same weaknesses. Promoting PrEP may be based on a different rational than promoting condoms but its actual use will have to face problem similar in scope to that of condom use. At the end of the day they both require a change in beahviour and sticking to it. This aspect of combination applies both to highly efficacious approaches which rely on behavior change and to intervention whose impact rely on political and financial commitment. What’s needed is a “pick and mix” combination.
“At this pivotal moment in the global response, we must courageously face up to the challenges presented by” new Combination Prevention and ensure that more research is done on approaches that have not been assessed yet (such as Test and Treat) and that the overall strategy combines a diversity of approaches. To be successful, Combination Prevention will have to include a number of approaches drawn from the different levels of the impact pyramid.
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Effectiveness is provided as the set point effectiveness with the 95% Confidence Interval which provides the range of value between which the true effectiveness resides. FEM-PREP data are not definitive and will be updated in the coming months.
The final quote originates from the UNAIDS strategy report 2011-2015.
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