Fast-tracking HIV prevention: scientific advances and implementation challenges
In 2014 the Joint United Nations Programme on HIV and AIDS (UNAIDS) reaffirmed its 2011 commitment to end the scourge of AIDS by 2030 (see Table 1). Recent articulations of this commitment are outlined in the UNAIDS Fast-Track Strategy and the UNAIDS 90-90-90 Strategy (UNAIDS, 2014a). If, indeed, targets are to be met, a long overdue rethink is needed about what works in HIV prevention.
Epidemics are social and relational phenomena spread and sustained by patterns of human settlement, movement, exchange and — in the case of HIV and AIDS — in large measure by risky sexual behaviours. The “human element” is in turn conditioned by environmental, cultural, political and socio-economic drivers. So as AIDS quickly developed into a pandemic, it soon became apparent that prevention initiatives would need to be tailored to the conditions of at-risk populations, in all their diversity; that general, top-down appeals to self-interest…