EDITORIAL: Combating HIVAids scourge requires going back to the basics

Ahead of World Aids Day 2015, UNAIDS has released a new report showing that countries are getting on the fast track to end Aids by 2030 as part of the Sustainable Development Goals.

By adapting to a changing global environment and maximising innovations, countries are seeing greater efficiencies and better results.

Progress in responding to HIV over the past 15 years has been extraordinary. By June 2015, UNAIDS estimates that 15.8 million people were accessing antiretroviral therapy, compared to 7.5 million in 2010 and 2.2 million in 2005. At the end of 2014, new HIV infections had fallen by 35 per cent since the peak in 2000 and Aids-related deaths fell by 42 per cent.

While Rwanda’s HIV prevalence has been contained at 3 per cent over the past decade, there is a concern that condom use, in particular among young sexually active people, remains low, increasing the risk of new infections.

This requires going back to basics, in particular the renowned “ABC” approach which employs population-specific interventions that emphasise abstinence for youth and other unmarried persons, including delay of sexual debut mutual faithfulness and partner reduction for sexually active adults and correct and consistent use of condoms by those whose behaviour places them at risk for transmitting or becoming infected with HIV.

Some of the most significant gains in the fight against HIV are a result of specific emphasis on, and funding of, programmes to promote changes in behaviour-related to fidelity in marriage, monogamous relationships, and reducing the number of sexual partners among sexually active unmarried persons.

Correct and consistent condom use programmes support the provision of full and accurate information about correct and consistent condom use reducing, but not eliminating, the risk of HIV infection and support access to condoms for those most at risk for transmitting or becoming infected.

Behaviours that increase risk for HIV transmission include engaging in casual sexual encounters, engaging in sex in exchange for money or favours, having sex with an HIV-positive partner or one of unknown status, abusing drugs or alcohol in the context of sexual interactions and using intravenous drugs.

Women can be at risk of becoming infected by their spouse, regular male partner or someone using force against them. Other high-risk groups include men who have sex with men and people employed away from home.

It should nonetheless be noted that existing research demonstrates that the correct and consistent use of condoms significantly reduces, but does not eliminate, risk of HIV infection.