HIV/AIDS prevention falling short

Less than one in five people at risk of HIV infection have access to basic prevention services, as current prevention efforts fall "significantly" short of what is needed, a new report has found.

"Twenty years into the AIDS epidemic, most people in the world still don't have access to effective HIV prevention," said Dr Helene Gayle, director of the Bill and Melinda Gates Foundation's global HIV/AIDS programme, and co-chair of the Working Group which released the report.

The report, "Access to HIV Prevention: Closing the Gap", examined the gap between HIV prevention needs and current efforts, and found that less than half of what is needed is being spent on prevention.

The Global HIV Prevention Working Group estimated that global funding for HIV prevention efforts in 2002 amounted to about US $1.9 billion - one third of what UNAIDS says will be needed annually by 2005.

Although Uganda, Senegal, Zambia and other African countries had made "enormous strides" against the epidemic by supporting interventions targeting key populations, there were still gaps in access.

Only eight percent of out-of-school youth and little more than one-third of in-school youth in sub-Saharan Africa had access to prevention programmes. About one in twelve sex workers and their clients were currently targeted by behavioural programmes.

But there were some prevention successes in Africa. In Zimbabwe, factories where peer-based HIV/AIDS education programmes were implemented had a 34 percent lower rate of new infections than workplaces with no prevention initiatives in place.

But while current donor contributions were enough to provide three condoms per year for every adult male in sub-Saharan Africa, an additional 1.9 billion condoms were needed annually to raise all countries to the level of countries like South Africa, Botswana and Kenya, which use the most condoms.

As part of the government's efforts in South Africa to scale up HIV prevention, public sector distribution of condoms rose from six million in 1994 to 358 million in 2002, the report noted. Researchers surveyed nearly 400 people who received more than 5,500 condoms and after five weeks, nearly 44 percent of the condoms had been used during sex.

The Working Group recommended the scaling-up of prevention efforts in every region, particularly "cost-effective, high-impact interventions", such as behaviour change programmes to delay the initiation of sexual activity, reduce the number of sexual partners, and promote the use of condoms, voluntary counselling and testing, and prevention of mother-to-child transmission.

Working Group members include UNAIDS, the World Health Organisation and the UN Children's Fund.

More details: www.unaids.org