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Quicker Action Needed on HIV Prevention

AVAC Executive Director Mitchell Warren.  (De Capua)
AVAC Executive Director Mitchell Warren. (De Capua)

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Joe DeCapua
An AIDS advocacy group says donors and researchers need to work smarter and faster to introduce prevention methods that people will actually use. AVAC says not enough has been done to capitalize on lessons learned from recent studies.


AVAC Executive Director Mitchel Warren said that it’s time for a “reality check” in HIV prevention research.

“Research has been a driving force in the AIDS response from its very beginning – for 30 plus years. And we often see research in one area and reality kind of in the terms of where science plays out in programs and activities on the ground. And what we tried to do in this year’s AVAC report is to really have a check on where we are with research and with HIV and AIDS, generally,” he said.

The non-profit organization has released a new report called – Research and Reality – at the 17th International Conference on AIDS and Sexually Transmitted Infections in Africa.

Warren, who attended the Cape Town meeting, said, “Over the last couple of years there’s been this cold rush to talk about the end of the epidemic and an AIDS-free generation. And we really wanted to look at where research is in its current form and where it might need to go to get us to the point that everyone’s talking about, which is this end of an epidemic.”

He said an AIDS-free generation is an aspirational goal. But he says big goals are needed to stop the spread of HIV.

“The first example, of course, is three by five. When WHO announced getting three-million people on treatment by 2005 people said ‘no way.’ And in fact the world did not reach that target. But we now have 10-million people on antiretroviral treatment. And here in South Africa this week, UNAIDS really committed to this 15 by 15 target – 15-million people to get on therapy by 2015. So, setting ambitious targets matters.”

The AVAC report calls for “better problem solving, more critical thinking and coordinated action around large-scale human trials and faster roll-out of proven options.”

Warren said, “A major part of this year’s report is really focused on a women’s HIV prevention research agenda. Because if we really look at the desire to move to an AIDS-free generation or ending an epidemic, it is very clear, particularly here in Africa, that we need to reprioritize and refocus our effort on how we develop additional prevention options that are going to help empower women to protect themselves from HIV. And we don’t have all the tools that we need. That is very, very clear.”

In recent years, studies have shown that particular microbicide gels -- and the use of antiretroviral drugs as a means of preventing HIV infection -- are very effective. But just because prevention methods work does not mean that people will use them.

“There have been huge challenges in getting people, men and women, particularly women in the trials, to adhere or to use these products on a regular basis. So, we really wanted to look at that issue to understand what needed to happen next to really help develop the tools and the options that some women can use some of the time to protect themselves from HIV. Because it is very clear that the current paradigm of option is just not enough to curb the level of infection,” he said.

Warren said that getting communities more involved in prevention research may help develop methods that people will use on a regular basis.

The AVAC report pays tribute to the late activist Spencer Cox of ACT UP and founder of the Treatment Action Group – and to South Africa’s Nelson Mandela.

“He said once that’s only impossible until you do it. And committing to the way forward is critical. And that’s really at the end of the day what we’re trying to say in this report. We must do it and I think we can do it,” said Warren.

In his later years, Mr. Mandela played a major role in the fight against HIV/AIDS, including through his foundation and children’s fund.

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