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Combination HIV prevention is an approach initially proposed by the United States in the President’s Emergency Plan for AIDS Relief (PEPFAR) and subsequently adopted and expanded in 2009 by the UNAIDS HIV Prevention Reference Group and updated in the UNAIDS 2015 report Fast-tracking combination prevention.

UNAIDS defines combination HIV prevention as rights-, evidence-, and community-based programs that promote a combination of biomedical, behavioral, and structural interventions designed to meet the HIV prevention needs of specific people and communities. Its goal is to reduce the number of new infections through activities with a greater sustained impact.

Well-designed combination prevention programs should be tailored to national and local needs, based on epidemiological information. Programs should also concentrate resources on combining activities where they are most needed. Structural interventions make it possible to create an enabling environment for the synergistic preventive action of the biomedical and behavioral components. Affected communities should be fully involved in these programs, mobilizing community, private sector, and government resources to achieve the necessary participation, coverage, and susainability and impact. WHO recommends a comprehensive package of health services for HIV prevention:

Antiretroviral Therapy Behavioral Interventions Condoms and Lubricants EMTCT Plus Harm Reduction Hepatitis B and C HIV Testing Services Mental Health PEP PrEP Sexual and Reproductive Health Sexually Transmitted Infections Tuberculosis and HIV Co-Infection Vaccination and Screening for HPV Voluntary Male Circumcision

Highlights