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Combination Prevention: A Deeper Understanding Of Effective HIV Prevention

C. Hankins, B. D. de Zalduondo
Published 2010 · Medicine

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Evidence-informed and human rights-based combination prevention combines behavioural, biomedical, and structural interventions to address both the immediate risks and underlying causes of vulnerability to HIV infection, and the pathways that link them. Because these are context-specific, no single prescription or standard package will apply universally. Anchored in ‘know your epidemic’ estimates of where the next 1000 infections will occur and ‘know your response’ analyses of resource allocation and programming gaps, combination prevention strategies seek to realign programme priorities for maximum effect to reduce epidemic reproductive rates at local, regional, and national levels. Effective prevention means tailoring programmes to local epidemics and ensuring that components are delivered with the intensity, quality, and scale necessary to achieve intended effects. Structural interventions, addressing the social, economic, cultural, and legal constraints that create HIV risk environments and undermine the agency of individuals to protect themselves and others, are also public goods in their own right. Applying the principles of combination prevention systematically and consistently in HIV programme planning, with due attention to context, can increase HIV programme effectiveness. Better outcome and impact measurement using multiple methods and data triangulation can build the evidence base on synergies between the components of combination prevention at individual, group, and societal levels, facilitating iterative knowledge translation within and among programmes.
This paper references
Risk and vulnerability reduction in the HIV / AIDS pandemic.
D. Tarantola (1995)
10.1080/09540120802626170
Household impacts of AIDS: using a life course approach to identify effective, poverty-reducing interventions for prevention, treatment and care
R. Loewenson (2009)
Behavior Change and hiv Prevention: (Re)Considerations for the 21st Century Global HIV PReVentIon WoRkInG GRouP
J. Auerbach (2008)
Multiple concurrent partnerships campaigns and communications towards a coordinated regional response
Towards universal access: scaling up priority HIV/AIDS interventions in the health sector. Progress report 2009
Organización Mundial de la Salud (2009)
Ogden J.Catalyzing quality improvements in HIV prevention: reviews of current practice, and presentation of a new approach
G Maguerez (2010)
10.1016/J.SOCSCIMED.2005.08.044
Behavioral science at the crossroads in public health: extending horizons, envisioning the future.
T. Glass (2006)
10.1097/QAD.0b013e32833062dc
Estimates of HIV incidence from household-based prevalence surveys
T. Hallett (2010)
10.1016/S0140-6736(08)60888-0
Coming to terms with complexity: a call to action for HIV prevention
P. Piot (2008)
Antiretroviral therapy for HIV infection in adults and adolescents: recommendations for a public health approach. 2006 revision.
B. Stilwell (2006)
for accelerated country action for women, girls, gender equality and HIV: operational plan for the UNAIDS action framework – addressing women, girls, gender equality and HIV
UNAIDS. Agend (2010)
10.1080/17441690802128321
Structural barriers and human rights related to HIV prevention and treatment in Zimbabwe
J. Amon (2009)
10.1016/S0140-6736(97)07439-4
Randomised, controlled, community-level HIV-prevention intervention for sexual-risk behaviour among homosexual men in US cities
J. Kelly (1997)
10.2105/AJPH.90.1.57
Outcomes of a randomized community-level HIV prevention intervention for women living in 18 low-income housing developments.
K. Sikkema (2000)
Technical update social change communication 2010. Geneva: UNAIDS
(2010)
HIV related entry and travel restrictions
Norway
10.1080/09614520600792507
The role of Ministries of Finance in implementing the ‘Three Ones’
Kizito Nsarhaza Bishikwabo (2006)
Combination Prevention: strategic HIV prevention programmes founded on good practice. A background paper for the UNAIDS Prevention Reference Group Meeting
Unaids (2009)
10.1126/SCIENCE.1093166
Population-Level HIV Declines and Behavioral Risk Avoidance in Uganda
R. Stoneburner (2004)
The limits of behavioral interventions for HIV prevention Prevention is primary: strategies for community well being
D Wohlfeiler (2007)
10.1371/journal.pone.0004997
HIV Prevalence, Risks for HIV Infection, and Human Rights among Men Who Have Sex with Men (MSM) in Malawi, Namibia, and Botswana
S. Baral (2009)
Practical guidelines for intensifying HIV prevention. Geneva: Joint United Nations Programme on HIV/AIDS United Nations General Assembly. Declaration of commitment on HIV/AIDS: five years later
Unaids (2006)
10.1097/QAD.0b013e328321e40b
The costs and effectiveness of four HIV counseling and testing strategies in Uganda
Nick Menzies (2009)
of the UNAIDS technical consultation on social change communication
UNAIDS. Repor (2007)
10.1371/journal.pmed.1000109
Male Circumcision for HIV Prevention in High HIV Prevalence Settings: What Can Mathematical Modelling Contribute to Informed Decision Making?
C. Hankins (2009)
The limits of behavioral interventions for HIV prevention
D Wohlfeiler (2007)
From advocacy to action: a progress report on UNAIDS at country level
(2005)
WHO Closing the gap in a generation: Health equity through action on the social determinants of health. In: Commission on social determinants of health
(2008)
Canadian Institutes of Health Research. CIHR Knowledge translation
Preventing HIV / AIDS in young people: a systematic review of the evidence from developing countries. UNAIDS Inter-agency Task Team on Young People.
Ross Da (2006)
10.1300/j104v36n01_01
Principles
R. C. Carter (2003)
Seal A.NewWHOgrowth standards: roll-out needs more resources
KeracM (2009)
Access to HIV prevention: closing the gap
Country coordinator survey analysis. Geneva: UNAIDS
(2008)
10.1007/s10461-009-9607-1
Comparing Couples’ and Individual Voluntary Counseling and Testing for HIV at Antenatal Clinics in Tanzania: A Randomized Trial
S. Becker (2009)
10.1093/IJE/28.1.10
Evaluation designs for adequacy, plausibility and probability of public health programme performance and impact.
J. P. Habicht (1999)
update social change communication 2010
UNAIDS. Technica (2010)
10.2105/AJPH.2007.120337
Evaluation of an HIV prevention intervention adapted for Black men who have sex with men.
K. T. Jones (2008)
Good participatory practices in biomedical HIV prevention trials
UnaidsAvac (2007)
Technical guidance note for global fund HIV proposals: gender-responsive HIV and AIDS programming for women and girls
Unaids Who (2010)
Understanding and challenging HIV stigma. Toolkit for action. A trainers' guide.
R. Kidd (2003)
the gap in a generation: Health equity through action on the social determinants of health
WHO. Closin (2008)
10.1016/S0140-6736(08)61690-6
Closing the gap in a generation: health equity through action on the social determinants of health
M. Marmot (2008)
10.1111/J.1728-4465.2004.00003.X
Where are the gaps? The effects of HIV-prevention interventions on behavioral change.
L. Bollinger (2004)
10.1097/01.aids.0000343768.85325.92
Impact of an intensive HIV prevention programme for female sex workers on HIV prevalence among antenatal clinic attenders in Karnataka state, south India: an ecological analysis
S. Moses (2008)
10.1016/S0140-6736(05)60646-0
UPDATE
angesichts der Corona-Pandemie (1998)
coordinator survey analysis
UNAIDS. Countr (2008)
An overview of combination prevention
Aidstar-One
Unauthorized reproduction of this article is prohibited Home testing for HIV infection in resource-limited settings
I Ganguli (2009)
World Bank GAMET/UNAIDS Project. Geneva: UNAIDS
World Unaids (2009)
Learning for the future: Innovative approaches to evaluating agricultural research
D Horton (2003)
PJ,GarnettGP.Appropriate evaluationofHIV prevention interventions: from experiment to full-scale implementation
TB Hallett (2007)
Addressing social drivers of HIV/AIDS some conceptual, methodological, and evidentiary considerations
JD Auerbach (2009)
10.1097/00002030-200006001-00001
Enriching the mix: incorporating structural factors into HIV prevention.
E. Sumartojo (2000)
prevention: UNAIDS policy position paper
HI UNAIDS. Intensifying (2005)
10.1016/S0140-6736(08)60887-9
Structural approaches to HIV prevention
G. R. Gupta (2008)
10.1097/QAD.0b013e3282f3f406
Male circumcision for HIV prevention: from evidence to action?
H. Weiss (2008)
Reducing HIV incidence in developing countries with structural and environmental interventions.
M. Sweat (1995)
10.1371/journal.pmed.0040260
Food Insufficiency Is Associated with High-Risk Sexual Behavior among Women in Botswana and Swaziland
S. Weiser (2007)
10.1097/00125817-200303000-00003
Diffusion of innovations
T. Valente (2003)
Outcomes of a randomized communitylevel HIV prevention intervention for women living in 18 lowincome housing developments
KJ Sikkema (2000)
United Nations Office of Drugs and Crime
(2009)
Communications framework for HIV / AIDS: a new direction.
Collins O. Airhihenbuwa (1999)
10.1136/sti.2006.020164
Short term estimates of adult HIV incidence by mode of transmission: Kenya and Thailand as examples
E. Gouws (2006)
Report of the UNAIDS technical consultation on social change communication
Unaids (2007)
From advocacy to action: a progress report on UNAIDS at country level
Unaids (2005)
Compendium of evidence-based HIV prevention interventions
10.1016/S0140-6736(08)60885-5
Biomedical interventions to prevent HIV infection: evidence, challenges, and way forward
N. Padian (2008)
10.1016/S0140-6736(08)60886-7
Behavioural strategies to reduce HIV transmission: how to make them work better
T. Coates (2008)
10.1097/01.aids.0000341772.48382.57
Introduction: Addressing the vulnerability of young women and girls to stop the HIV epidemic in southern Africa
M. Stirling (2008)
10.1016/S0140-6736(09)61266-6
New WHO growth standards: roll-out needs more resources
M. Kerac (2009)
10.1097/QAD.0b013e3283313e83
HIV prevention intervention to reduce HIV-related stigma: evidence from China
L. Li (2010)
Creating an enabling environment: lessons learnt from the Sonagachi Project
S Jana (1999)
10.1097/00002030-199512000-00001
Enabling approaches for HIV/AIDS prevention: can we modify the environment and minimize the risk?
O. Tawil (1995)
Addressing social drivers of HIV/AIDS some conceptual, methodological, and evidentiary considerations. London: London School of Hygiene and Tropical Medicine
J D Auerbach (2009)
What happened in Uganda? Declining HIV prevalence behavior change and the national response.
Hogle Ja (2002)
10.1016/J.SOCSCIMED.2006.03.026
Should structural interventions be evaluated using RCTs? The case of HIV prevention.
C. Bonell (2006)
on the Global AIDS Epidemic
UNAIDS. Repor (2008)
Multiple concurrent partnerships campaigns and communications towards a coordinated regional response
EM Rogers (2007)
Global HIV Prevention Working Group. Access to HIV prevention: closing the gap
(2001)
Practical guidelines for intensifying HIV prevention
(2007)
Advice: antiretroviral therapy for HIV infection in adults and adolescents. Geneva: World Health Organization
Who (2009)
strategic HIV prevention programmes founded on good practice
UNAIDS. Combination Prevention (2009)
RP.Home testing for HIV infection in resource-limited settings.Curr HIV/AIDS
I Ganguli (2009)
Prevention Is Primary: Strategies for Community Well Being
L. Cohen (2010)
concurrent partnerships campaigns and communications towards a coordinated regional response
UNAIDS. Multipl (2008)
Technical update social change communication 2010
Unaids (2010)
HIV prevention response and modes of transmission (MOT) analysis
L Gelmon (2009)
10.1097/01.aids.0000327435.28538.18
Gender and AIDS: time to act.
A. Greig (2008)
Technical guidance note for global fund HIV proposals: gender-responsive HIV and AIDS programming for women and girls. Geneva: UNAIDS/WHO
UnaidsWho (2010)
10.1136/sti.2008.029892
Changes in sexual behaviour leading to the decline in the prevalence of HIV in Uganda: confirmation from multiple sources of evidence
D. Kirby (2008)
10.2499/0896291421rr139
PROGRESA and Its Impacts on the Welfare of Rural Households in Mexico
E. Skoufias (2005)
BEhavIOR ChaNgE aNd hIv PREvENtION : ( re ) Considerations for the 21
Executive Summary (2008)
Microbicides urgently needed: statement by IPM CEO, Zeda Rosenberg, on new AIDS statistics. Joint United Nations Programme on HIV/AIDS (UNAIDS) releases the 2004 AIDS epidemic update.
Z. Rosenberg (2004)
10.1097/QAD.0b013e328307a040
A combined microfinance and training intervention can reduce HIV risk behaviour in young female participants
P. Pronyk (2008)
guidelines for intensifying HIV prevention
UNAIDS. Practica (2007)
10.1097/00002030-200006001-00003
Structural interventions in public health
K. Blankenship (2000)
Rapid Advice: antiretroviral therapy for HIV infection in adults and adolescents
(2009)
10.1056/NEJMoa0908492
Vaccination with ALVAC and AIDSVAX to prevent HIV-1 infection in Thailand.
S. Rerks-Ngarm (2009)
World Bank GAMET/UNAIDS Project. Geneva: UNAIDS
Unaids (2009)
prevention: UNAIDS policy position paper
UNAIDS. IntensifyingHI (2005)
Sex, Rights and the Law in a World with AIDS
J. Ogden (2009)
10.1016/j.socscimed.2008.01.023
Is social capital associated with HIV risk in rural South Africa?
P. Pronyk (2008)
HIV/AIDS behaviour change communication toolkit for the workplace
ILO-FHI. ILO-FH (2009)
global strategy framework on HIV/AIDS
UNAIDS. Th (2001)
Guide to a strategic planning process for a national response
Unaids (1998)
10.7748/ns.3.20.18.s35
AIDS research.
J. L'age-Stehr (1989)
Guide to a strategic planning process for a national response
(1998)
ILO-FHI HIV/AIDS behaviour change communication toolkit for the workplace. Geneva: International Labour Organization
Ilo-Fhi (2009)
National Agency for the Control of AIDS. National HIV/AIDS response 2005-2009. Abuja: National Agency for the Control of AIDS
(2009)
Intensifying HIV prevention: UNAIDS policy position paper
Unaids (2005)
spending assessment
AID UNAIDS. National (2009)
2005
OECD. Paris Declaration (2010)
10.1371/journal.pmed.0040314
Squaring the Circle: AIDS, Poverty, and Human Development
P. Piot (2007)
CORO and Horizons/Population Council. Sakhi Saheli: promoting gender equity and empowering young women -a training manual
(2008)
Addressing Young People's Vulnerability to HIV, STIs and Early Pregnancy. Conceptual Communication Framework for a Coordinated National Response in Uganda
Aids Uganda (2007)
Creating an enabling environment: lessons learnt from the Sonagachi Project, India
S Jana (1999)
Kenya - HIV prevention response and modes of transmission analysis
M. Prestidge (2009)
Joint United Nations Programme on HIV/AIDS.
R. J. O'connell (2004)
Strategies for an Expanded and Comprehensive Response (ECR) to a national HIV / AIDS epidemic. A handbook for designing and implementing HIV / AIDS programs.
Lamptey Pr (2001)
of the UNAIDS HIV Prevention Reference Group Meeting; 2–4 March 2009; Glion, Switzerland
UNAIDS. Repor (2009)
10.1016/S0140-6736(06)69744-4
Effect of a structural intervention for the prevention of intimate-partner violence and HIV in rural South Africa: a cluster randomised trial
P. Pronyk (2006)
Conceptual Communication Framework for a Coordinated National Response in Uganda. Kampala: Uganda AIDS Commission
Aids Uganda (2007)
United Nations General Assembly Special Session. Declaration of Commitment on HIV/AIDS
(2001)
Good participatory practices in biomedical HIV prevention trials
Unaids (2007)
Agenda for accelerated country action for women, girls, gender equality and HIV: operational plan for the UNAIDS action framework -addressing women, girls, gender equality and HIV
(2010)
Learning for the future: Innovative approaches to evaluating agricultural research. In: Agricultural systems
D Horton (2003)
Combination Prevention: strategic HIV prevention programmes founded on good practice. A background paper for the UNAIDS Prevention Reference Group Meeting; 3-5
10.1097/QAD.0b013e328337798a
Weighing the gold in the gold standard: challenges in HIV prevention research
N. Padian (2010)
10.1016/S0140-6736(08)61752-3
Combination HIV prevention
M. Merson (2008)
AIDS, health, and human rights
J Mann (1993)
10.1016/J.SOCSCIMED.2004.12.024
The social structural production of HIV risk among injecting drug users.
T. Rhodes (2005)
Towards universal access: scaling up priority HIV/AIDS interventions in the health sector. Geneva: World Health Organization
WhoUnaidsUnicef (2009)
Country coordinator survey analysis
Unaids (2008)
Merieux Foundation Declaration of Commitment on HIV/AIDS
J Mann (1993)
10.1136/sti.2006.023663
Appropriate evaluation of HIV prevention interventions: from experiment to full-scale implementation
T. Hallett (2007)
UNAIDS. Three Ones principles
(2004)
10.1016/S0140-6736(08)60889-2
Making HIV prevention programmes work
S. Bertozzi (2008)
United Nations General Assembly. Declaration of commitment on HIV/AIDS: five years later
(2006)
Prevention of the sexual transmission of HIV-1: a view from early in the 21st century
M. Cohen (2008)
advocacy to action: a progress report on UNAIDS at country level
UNAIDS. Fro (2005)
10.1126/science.1178746
Broad and Potent Neutralizing Antibodies from an African Donor Reveal a New HIV-1 Vaccine Target
L. Walker (2009)
epidemic update
AID UNAIDS. (2006)
10.1097/COH.0b013e32830136a0
Understanding and integrating the structural and biomedical determinants of HIV infection: a way forward for prevention
S. Kippax (2008)
of the UNAIDS HIV Prevention Reference GroupMeeting; 2–4March 2009;Glion, Switzerland
UNAIDS. Repor (2009)
10.1007/S11904-009-0029-5
Home testing for HIV infection in resource-limited settings
Ishani Ganguli (2009)
Effectiveness of HIV prevention interventions in developing countries.
M. Merson (2000)
to a strategic planning process for a national response
UNAIDS. Guid (1998)
on the global AIDS epidemic
UNAIDS. Repor (2004)
10.1186/1471-2458-7-349
Promotion of couples' voluntary counselling and testing for HIV through influential networks in two African capital cities
S. Allen (2007)
An overview of combination prevention
Aidstar One (2009)
Catalyzing quality improvements in HIV prevention: reviews of current practice, and presentation of a new approach
G Maguerez (2010)
Multiple concurrent partnerships campaigns and communications towards a coordinated regional response In: Report Meeting of HIV Prevention Communications Practitioners
Unaids (2008)
10.1080/13576270701782720
AIDS in the twenty-first century: Disease and globalization
S. Kippax (2008)
Proceedings of the UNAIDS Wilton Park Think Tank on Evaluation Methods for HIV Prevention
(2009)
Methods for Prevention Packages' research programme



This paper is referenced by
10.7448/IAS.15.3.17367
HIV prevention, structural change and social values: the need for an explicit normative approach
J. Parkhurst (2012)
Comparison of HIV-Related Knowledge, Attitudes, and Behavior Among People Aged 15-49 Years Between Lesotho and Senegal
Sophoan Tun (2013)
10.4172/2155-6113.1000200
The Rationale, Design, and Initial Efficacy of SystemCHANGE™ -HIV: A Systems-Based Intervention to Improve Physical Activity in People Living with HIV
A. Webel (2013)
10.2165/11596500-000000000-00000
Counting the Cost of Not Costing HIV Health Facilities Accurately
E. Beck (2012)
Depoliticising an Epidemic – International Aids Control and the Politics of Health in Tanzania
M. Hunsmann (2013)
Access to the Local AIDS Service Organization among African, Caribbean and Other Black Residents of Middlesex-London, Ontario, Canada
Soraya Blot (2014)
HIV in Victoria's African communities: reducing risks and improving care
Christopher Lemoh (2013)
The Price of Prevention: Cost Effectiveness of Biomedical HIV Prevention Strategies in South Africa.
N. Moodley (2016)
10.2147/HIV.S46585
Current perspectives in HIV post-exposure prophylaxis
B. Sultan (2014)
10.1007/s10461-013-0418-z
A Systematic Review to Identify Challenges of Demonstrating Efficacy of HIV Behavioral Interventions for Gay, Bisexual, and Other Men Who Have Sex with Men (MSM)
Darrel H. Higa (2013)
10.1016/J.JVAL.2020.06.013
Prioritizing Additional Data Collection to Reduce Decision Uncertainty in the HIV/AIDS Response in 6 US Cities: A Value of Information Analysis.
Xiao Zang (2020)
Externalities and Complementarities of HIV / AIDS Prevention Programs : Evidence from Secondary Schools in Malawi ∗
Booyuel Kim (2015)
10.1371/journal.pone.0207005
Global and regional trends of people living with HIV aged 50 and over: Estimates and projections for 2000–2020
Christine S. Autenrieth (2018)
10.1093/HEAPRO/DAV061
Development of a theory-guided pan-European computer-assisted safer sex intervention.
C. Nöstlinger (2016)
10.1007/978-3-319-46013-0_7
Context Matters! But Why?
Hakan Seckinelgin (2017)
10.1080/00918369.2017.1422941
Risk Behaviors Among Young Men Who Have Sex With Men in Bangkok: A Qualitative Study to Understand and Contextualize High HIV Incidence
Tareerat Chemnasiri (2019)
HIV Action Plan: Action 9 (HIV prevention evidence synthesis on MSM)
K. Lorimer (2010)
Circumcision for HIV Prevention: New Mathematical Models for Strategic Demand Creation Prioritizing Subpopulations by Age
Catherine A. Hankins (2018)
10.1371/journal.pone.0100058
Improving Ethical and Participatory Practice for Marginalized Populations in Biomedical HIV Prevention Trials: Lessons from Thailand
D. Allman (2014)
10.1371/journal.pone.0169499
Correction: Voluntary Medical Male Circumcision for HIV Prevention: New Mathematical Models for Strategic Demand Creation Prioritizing Subpopulations by Age and Geography
C. Hankins (2016)
FOR ADDRESSING THE STRUCTURAL DETERMINANTS OF HIV
P. Lutz (2013)
10.1186/s12889-018-6156-4
Stigma reduction in relation to HIV test uptake in low- and middle-income countries: a realist review
Subash Thapa (2018)
10.1097/COH.0b013e328343ad7e
Uptake of biomedical interventions for prevention of sexually transmitted HIV.
U. Abbas (2011)
10.1007/s11904-013-0156-x
Overview of the Current State of the Epidemic
C. Hankins (2013)
10.1371/journal.pmed.1001127
Voluntary Medical Male Circumcision: An Introduction to the Cost, Impact, and Challenges of Accelerated Scaling Up
C. Hankins (2011)
10.1596/978-1-4648-0524-0/CH7
Cost-Effectiveness of Interventions to Prevent HIV Acquisition
G. Garnett (2017)
10.1093/her/cyr021
The rapidly changing paradigm of HIV prevention: time to strengthen social and behavioural approaches.
J. D. de Wit (2011)
10.7448/IAS.18.4.20527
PrEP Implementation Science: State-of-the-Art and Research Agenda
C. Cáceres (2015)
10.1007/s40273-019-00817-1
Structural Design and Data Requirements for Simulation Modelling in HIV/AIDS: A Narrative Review
Xiao Zang (2019)
Using mathematical models to characterize HIV epidemics for the design of HIV prevention strategies
S. Mishra (2014)
Policy and programme responses for addressing the structural determinants of HIV.
P. Pronyk (2013)
The road to success. Long-term prognosis for persons living with HIV in Denmark - time trends and risk factors.
N. Lohse (2016)
See more
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