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Preventing HIV

BMJ 2003; 326 doi: (Published 19 June 2003) Cite this as: BMJ 2003;326:1342
  1. Arthur J Ammann, president (
  1. Global Strategies for HIV Prevention, 104 Dominican Drive, San Rafael, CA 94901, USA

    Time to get serious about changing behaviour

    It is not easy to write about preventing HIV when we are failing at it. For two decades we have known how to prevent every single route of transmission-sexual intercourse, infected blood products, intravenous drug use, accidental inoculation, perinatal transmission, and breast feeding.1 Yet the number of people infected with HIV worldwide is estimated at 42 million, with some 5 million new infections each year.2 How can this be?

    Some argue that there is not enough money; others that it is too difficult to change the behaviours that contribute to the spread of HIV. But if behaviour cannot be changed then no amount of money is going to make a big difference in prevention because every successful form of prevention requires change in behaviour.

    Governments must change the way they view HIV and AIDS by rearranging priorities for spending. Overall more people are killed by HIV than invading troops. Ministries of health and national public health agencies must supply the resources to test all blood donors and enforce regulations against use of untested blood products, avoiding the continued unnecessary infection of hundreds of thousands of individuals. …

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