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close this bookAIDS, Poverty Reduction and Debt Relief - A Toolkit for Mainstreaming HIV/AIDS Programmes into Development Instruments (UNAIDS, 2001, 48 p.)
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View the documentAcronyms and abbreviations
View the documentForeword
View the documentSummary
close this folder1. Introduction
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View the document1.1. What is this Toolkit for?
View the document1.2. To whom it is addressed?
View the document1.3. Links between HIV/AIDS and poverty
close this folder2. The National AIDS Programme as a Contribution to Poverty Reduction
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View the document2.1. Rationale
close this folder2.2. What works against HIV/AIDS?2
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View the document2.2.1. An enabling environment across multiple sectors
View the document2.2.2. Preventing HIV infection
View the document2.2.3. Care, support and impact mitigation
View the document2.2.4. Mobilization of resources
close this folder3. The Essential HIV/AIDS Content in the PRSP and HIPC Documents
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View the document3.1. What are PRSPs?
View the document3.2. An introduction to debt relief
close this folder3.3. Making the case for HIV/AIDS control in the PRSP and HIPC documents
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View the document3.3.1. Aids as a cause of poverty and poverty as a contributor to AIDS
View the document3.3.2. Strategies derived from the national AIDS plan
View the document3.3.3. Medium-term goals and poverty monitoring indicators
View the document3.3.4. Short-run actions that could be part of agreements for debt relief
View the document3.3.5. How has HIV/AIDS been included in PRSPs?
View the document3.3.6. HIV/AIDS conditionalities used in HIPC in 2000
close this folder4. Uses of Funds Released Through HIPC - Earmarking, Channeling, and Accountability
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View the document4.1. Earmarking
View the document4.2. Channeling funds to local initiatives
View the document4.3. Accountability
close this folder5. Influencing Policies
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View the document5.1. Building coalitions
View the document5.2. Strengthening capacity
close this folder6. Conclusions
View the document6.1. PRSP, debt relief and AIDS: Just another source of funding or a new opportunity?
View the document6.2. Next steps
View the documentReferences
View the documentAppendix 1. Links between HIV/AIDS and Poverty
View the documentAppendix 2. Indicators
View the documentAppendix 3. Selected Websites on AIDS, Poverty and Debt Relief
View the documentBack Cover

2.2.2. Preventing HIV infection

There are still few systematic reviews of the evidence on preventive interventions in the published literature. Merson et al. (2000) reviewed the effectiveness of projects and programmes in developing countries that aim to reduce sexual transmission of HIV infection or transmission related to injection drug use. They found that behavioural change interventions are effective when targeted to populations at high risk, particularly female sex workers and their clients. Few studies have evaluated harm reduction interventions in injecting drug users (IDUs). Evidence on the effectiveness of voluntary counselling and testing programmes was mixed, and results varied according to the population being studied. STI treatment appeared highly effective in reducing HIV/STI transmission, particularly in the earlier stages of the epidemic. Structural and environmental interventions show great promise, although more evaluation is needed. Merson et al. concluded that:

· HIV prevention interventions can be effective in changing risk behaviours and preventing transmission in low- and middle-income countries;

· when the appropriate mix of interventions is applied, they can lead to significant reductions in the prevalence of HIV at the national level; and

· additional research is needed to identify effective interventions, particularly in men who have sex with men, youth, IDUs and HIV -infected persons.

In practice, countries will strike a pragmatic balance, based on the capacity for programme implementation, the expected effects of interventions, their political feasibility and the availability of financial resources. For practical purposes, countries would need to consider interventions aimed at reducing risk and those aimed at reducing vulnerability (Table 1).

Table 1. Interventions for prevention of HIV infection