For each route of transmission there are things that an individual can do to reduce or eliminate risk. There are also interventions that have been proven to work at the community, local and national level.
To be successful, an HIV prevention programme must make use of all approaches known to be effective, rather than just implementing one or a few select actions in isolation. The share of resources allocated to each area should reflect the nature of the local epidemic - for example, if most infections occur among men who have sex with men then this group should be a primary target for prevention efforts.
Although most of this page looks separately at each transmission route, it should be remembered that many people don’t fit into only one “risk category”. For example, injecting drug users need access to condoms and safer sex counselling as well as help to reduce the risk of transmission through blood.
HIV can be transmitted in three main ways:
- Sexual transmission
- Transmission through blood
- Mother-to-child transmission
Wherever there is HIV, all three routes of transmission will take place. However the number of infections resulting from each route will vary greatly between countries and population groups.
First requirements
There are three key things that can be done to help prevent all forms of HIV transmission. First among these is promoting widespread awareness of HIV and how it can be spread. Media campaigns and education in schools are among the best ways to do this.
Another essential part of a prevention programme is HIV counselling and testing. People living with HIV are less likely to transmit the virus to others if they know they are infected and if they have received counselling about safer behaviour. In particular, a pregnant woman who has HIV will not be able to benefit from interventions to protect her child unless her infection is diagnosed. Those who discover they are uninfected can also benefit, by receiving counselling on how to remain that way.1 2
The third key factor is providing antiretroviral treatment. This treatment enables people living with HIV to enjoy longer, healthier lives, and as such it acts as an incentive for HIV testing. It also brings HIV-positive people into contact with health care workers who can deliver prevention messages and interventions. Studies suggest that HIV-positive people may be less likely to engage in risky behaviour if they are enrolled in treatment programmes. Nevertheless, it is also possible that widespread availability of treatment may make some members of the wider population less fearful of HIV infection, and hence less willing to take precautions.3 4
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