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Moving beyond the alphabet soup of HIV prevention

Collins, Chrisa; Coates, Thomas Jb; Curran, Jamesc

doi: 10.1097/01.aids.0000327431.82795.49

The ‘ABCs’ of prevention (abstinence, be faithful, use a condom) continue to be the subject of intense debate in the international dialogue on HIV/AIDS prevention policy. The authors argue that the ABC terminology infantilizes the prevention discussion by excluding essential interventions and oversimplifying the prevention challenge facing countries. The dialogue that is needed is less about the relative merits of one intervention over another, but rather how to promote comprehensive national prevention programmes that have a measurable impact on HIV incidence. Accountability is key to advancing HIV prevention on the national and international levels. Governments, donors and global agencies must be held accountable for prevention programming that is tailored to the specific characteristics of national epidemics, brings quality interventions to a scale, addresses environmental factors in vulnerability, and links prevention and treatment services. Whereas each national prevention response must remain unique, policy makers, donors and advocates can assess a country's prevention programming by the degree to which it is designed, scaled and implemented to make impact over time.

aIndependent consultant and member of International Treatment Preparedness Coalition (ITPC), USA

bUCLA Program in Global Health, UCLA David Geffen School of Medicine, Los Angeles, California, USA

cRollins School of Public Health, Emory University, Atlanta, Georgia, USA.

Correspondence to Chris Collins, ITPC, Maplewood, NJ, USA. Tel: +1 845 701 0158; fax: +1 530 380 3822; e-mail:

© 2008 Lippincott Williams & Wilkins, Inc.