HIV prevention efforts will not succeed

HIV prevention efforts will not succeed in the long term unless the underlying drivers
of HIV risk and vulnerability are effectively addressed.75 The evidence base for structural
interventions is limited but there is wide recognition that these are a critical component
of combination prevention.76 Factors that commonly contribute to vulnerability to HIV
infection include gender inequality, discrimination and social exclusion77. These same
structural issues, together with poverty, mobility and displacement, may lead people to
engage in sex work and increase their vulnerability to HIV
Addressing Societal Causes of HIV Risk and Vulnerability:

• Long-term success in responding to the HIV epidemic will require sustained progress in
• addressing human rights violations, gender inequality, stigma, and discrimination.
• Significant investment in girls’ education, supported by policies mandating universal
• primary and secondary education, would substantially reduce HIV risk and vulnerability
• for women and girls.
• Evidence-informed programmes to forge norms of gender equity should be brought
• to scale, with particular attention to initiatives focused on men and boys.
• National governments and international donors should prioritize strategies to
• increase women’s economic independence and legal reforms to recognize women’s
• property and inheritance rights.
• All countries should ensure rigorous enforcement of antidiscrimination measures to
• protect people living with HIV. The one third of countries that lack legal protections
• against HIV-based discrimination should immediately enact such laws. Countries
• should also protect populations most at risk from discrimination and ensure their
• equal enjoyment of human rights.
• Countries should include anti-stigma strategies as integral components of their
• national AIDS plans, investing in a broad range of activities, including public
• awareness and ”know your rights” campaigns, legal services for people living with
• HIV, expansion of access to antiretroviral drugs, and expressions of national solidarity
• in the HIV response.
• Much stronger financial and technical support is needed for capacity-building for
• organizations and networks of people living with HIV, and groups of people most at
• risk of HIV infection.