The ABCs of HIV Prevention

The ABCs of HIV Prevention
(A) Abstinence refers to not engaging in sexual intercourse
Sexual expression is a natural and healthy part of life, however, for certain
periods during one’s life, one may choose to abstain from all sexual expression
or from higher-risk activities such as penetrative sexual intercourse. Prevention
strategies encouraging delay of sexual initiation or debut help young people
to postpone sexual intercourse until they have developed the personal and
social skills that will enable them to practise protected intercourse. The goal of
delay-oriented programmes is to facilitate the development of young people’s
capacities for informed decision-making regarding their sexual health, including
the prevention of pregnancy and sexually transmitted infections (STIs), including
HIV. Whether abstinence occurs as a delay of sexual debut or as adoption of
a period of abstinence at a later stage, access to information and education
about alternative safer sexual practices is critical to avoid HIV infection on sexual
initiation or resumption of sexual activity.
(B) Being safer by being faithful to one’s partner or reducing the number of
sexual partners
The lifetime number of sexual partners is a very important predictor of HIV
infection. Thus, having fewer sexual partners reduces the risk of HIV exposure.
However, strategies to promote faithfulness among couples do not necessarily
lead to lower incidence of HIV unless neither partner has HIV infection and both
are consistently faithful.
(C) Condom use refers to consistent and correct use of condoms, both
male and female
Effective condom promotion within a combination prevention strategy must
involve the equally important and interrelated components of informed choice,
empowerment, supportive environment, demand and supply. To meet the
needs and socioeconomic conditions of all population groups, greater access
to, and availability of, condoms should be ensured through diverse channels,
including free distribution, commercial sale and social marketing programmes.
Condoms need to be actively promoted among sexually active young people
and other populations at higher risk of HIV exposure such as sex workers and
their clients, men who have sex with men (MSM), and people with HIV and their
partners. Studies conducted by the US National Institutes of Health and the US
Centers for Disease Control and Prevention (CDC) have found that, without
access to condoms, other prevention strategies lose much of their potential
effectiveness. In addition, for young people, condom education and promotion
are most effective within the context of life-skills education to help them make
responsible decisions related to sexual behaviour and reproductive health.