Prevention of HIV TransmissionCaribbean Regional Strategic Framework on HIV 2014-2018
Preventing new infections continues to be the cornerstone of a sustainable and successful regional response. While results have been achieved, most notably in preventing mother-to-child transmission, accelerating prevention efforts is an imperative in the context of diminishing financial resources for HIV. The goal of eliminating transmission to children is within reach, and can be achieved by simplifying and expanding ART for all pregnant women, and by ensuring continuity of treatment to lower lifetime transmission rates.
Treatment programmes are also faced with the long-term prospect of supporting increasing numbers of people on ART for longer periods, as AIDS-related mortality declines and countries move towards implementing the 2013 WHO Treatment Guidelines. Small declines in infection rates will not be enough to off-set these costs, and maximizing impact and value for-money requires a combination prevention approach with a range of evidence-based behavioural and biological interventions appropriate to the country context and to the needs of key populations at higher risk. Resources must be targeted to where the epidemic is at the country, community and individual levels. Doing so effectively will require establishing and sustaining an enabling environment (SPA 1) by addressing social and cultural drivers of the epidemic and by removing barriers to service access. In particular, more conscious efforts to address human sexuality are needed in order to equip young people with the knowledge and tools they need for healthy development. In many countries, economic and social support programmes, including the use of community platforms for service delivery, the provision of incentives to promote health seeking behaviours, and food and nutrition support, show promise in reducing vulnerability to HIV infection. These can be built upon, supported by the requisite research and M&E, for more holistic and integrated prevention approaches.
Strategic objective 3.1: Universal access to high-quality, evidence-based and appropriately targeted packages of prevention services.
- Country-appropriate prevention strategies include high-impact interventions, such as increased coverage of HIV testing, counselling and treatment; widespread accessibility and use of condoms; and expanded access to STI testing and treatment.
- Interventions are tailored to meet the needs of key populations, and uptake of services is increased.
- Age-appropriate, gender-sensitive, evidence-informed programmes that provide comprehensive sexual and reproductive health education are being delivered throughout the education sector and in community settings.
- Male and female condoms and lubricants are consistently available through appropriate distribution channels. Comprehensive and integrated SRH services are being delivered.
- Technical guidance and support is provided to establish and maintain high-quality standards for safe and effective prevention programmes.
- Operational research is conducted to identify best practices and to inform the applicability of evidence-informed practices such as voluntary medical male circumcision and post-exposure prophylaxis (PEP).
Strategic objective 3.2: Scale-up access to high-quality interventions for the elimination of mother-to-child transmission.
- EMTCT interventions are integrated into MCH and SRH programmes.
- Lifelong ART treatment is offered to all HIV positive pregnant women, regardless of CD4 count.
- The 2013 WHO Treatment Guidelines are adapted for national use.
- Linkages to ART are strengthened to improve retention in treatment post-delivery to ensure continuity if subsequent pregnancies occur.
- Early infant diagnosis is provided for all HIV-exposed
Related Documents for Strategic Area 3: Prevention of HIV Transmission