Heleen Vermandere

During this session, preventive methods other than prep were discussed. Biomedical breakthroughs tend to take our attention away from other, maybe older but also effective approaches. At the same time, research investments focus on the next innovation instead of also ensuring implementation of already known preventive strategies.

While prep offers great prevention, other interventions remain important. Modeling data pointed out that among 5 major determinants of HIV infection – inter-personal violence, age disparity, transactional sex, low school attendance and depression – interventions that address the latter 3 are most likely to reduce HIV incidence among South-African girls. Furthermore, offering a package of health services increases the uptake of both: in Tanzania, early infant male circumcision was linked with higher uptake of post-natal care services. Similarly, using popular venues (churches) and attractive events (baby showers) can improve HIV testing and if needed PMTCT, as was showed by a program in Nigeria. Also condom use enforcement remains important: south-African, female sex workers are unlikely to use condoms with their main partners, regardless of their prep use. Past prep users struggled with condom use in general, pointing out how intervention that are less user dependent would serve them more.

A presentation by Mitchell Warren showed how research investments do not prioritize key populations mentioned in policy strategies, and new preventive methods remain relying on biomedical science, overseeing social and political issues. Similarly, the products and approaches designed to respond the epidemic in HIC, leaving LMIC behind.