What are the living principles of a positive prevention strategy and how should these be put into practice?

What are the living principles of
a positive prevention strategy and
how should these be put into
practice?
The following four guiding principles
determine both the validity and content
of a positive prevention approach:
􀂄 Promotion of human rights: This
should ensure the right to privacy,
confidentiality, informed consent and
voluntary disclosure. Protection of
the rights of people living with HIV
needs to be guaranteed. Stigma and
discrimination – including self stigma
– drive people underground and
make prevention even more difficult.
A supportive and enabling legal
environment is a fundamental
cornerstone as it recognizes that
prevention strategies based on
coercion and criminalization are not
the answer.
􀂄 Involvement of people living with HIV:
People living with HIV must be
involved in the decisions relating to
their life. In accordance with the
Greater Involvement of People
Living with HIV (GIPA)3 Principle,
the active engagement of people
living with HIV in determining their
own unique prevention reality is key
to success in ensuring relevance,
efficacy and applicability.
􀂄 Embracing shared ownership and
responsibility: Of particular importance
is that positive prevention places the
responsibility for reducing HIV
transmission on everybody and
removes the undue burden on
people who are aware of their status.
Safer and responsible sexual
behaviour is the responsibility of all
partners – irrespective of status.
Promoting a culture of shared
responsibility could also improve
communication and equality within
relationships.
􀂄 Recognition of diversity: People
living with HIV are heterogeneous
and represent a cross section of all
sectors of society. Issues of race,
ethnicity, gender, orientation, age,
language, and risk profile will all have
an effect on how positive prevention
initiatives need to be tailored.
What positive prevention is and
what it is not
While there is consensus on what the
purpose of positive prevention is, there
is still a lack of coherence on the actual
term. Some have referred to it as
‘prevention for positives,’ ‘prevention
interventions for people living with HIV’
and ‘prevention for by and with people
living with HIV.’ The term ‘positive
prevention’ is at times also confused
with the development of upbeat and
supportive mainstream and primary
prevention messages aimed at
predominantly HIV-negative people.
Irrespective of the term used, the four
building blocks of a positive prevention
approach aim to proactively address the
sexual and health needs of people living
with HIV.