Institutional members access full text with Ovid®

Integrating HIV care and HIV prevention: legal, policy and programmatic recommendations

Remien, Robert Ha; Berkman, Alanb; Myer, Landonc; Bastos, Francisco Id; Kagee, Ashrafe; El-Sadr, Wafaa Mb,f

doi: 10.1097/01.aids.0000327437.13291.86
Equity

Since the start of the HIV epidemic we have witnessed significant advances in our understanding of the impact of HIV disease worldwide. Furthermore, breakthroughs in treatment and the rapid expansion of HIV care and treatment programmes in heavily impacted countries over the past 5 years are potentially critical assets in a comprehensive approach to controlling the continued spread of HIV globally. A strategic approach to controlling the epidemic requires continued and comparable expansion and integration of care, treatment and prevention programmes. As every new infection involves transmission, whether vertically or horizontally, from a person living with HIV/AIDS (PLWHA), the integration of HIV prevention into HIV care settings has the potential to prevent thousands of new infections, as well as to improve the lives of PLWHA. In this paper, we highlight how to better utilize opportunities created by the antiretroviral roll-out to achieve more effective prevention, particularly in sub-Saharan Africa. We offer specific recommendations for action in the domains of healthcare policy and practice in order better to utilize the advances in HIV treatment to advance HIV prevention.

aHIV Center for Clinical and Behavioral Studies, NY State Psychiatric Institute and Columbia University, New York, New York, USA

bInternational Center for AIDS Care and Treatment Programs (ICAP) and Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York, USA

cInfectious Diseases Epidemiology Unit, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa

dOswaldo Cruz Foundation – FIOCRUZ, Rio de Janeiro, Brazil

eDepartment of Psychology, Stellenbosch University, Cape Town, South Africa

fHarlem Hospital Center, New York, New York, USA.

Correspondence to Robert H. Remien, PhD, HIV Center for Clinical and Behavioral Studies, NY State Psychiatric Institute and Columbia University, New York, New York, USA. Tel: +1 212 543 5375; fax: +1 212 543 6003; e-mail: rhr1@columbia.edu

© 2008 Lippincott Williams & Wilkins, Inc.