GENEVA, 8 March 2012—On this International Women's day the world has a lot more to do if it is to be a place where:

• Women and men, girls and boys are treated as equal
• Girls shape their own future
• Boys challenge social norms that block opportunities
• HIV does not take away people’s dignity and rights.

The reality is very different:

• Every minute, a young woman is newly infected by HIV
• At the same time, girls lack equal access to education
• Far too many women lack control over their finances and assets
• And too many women continue to lack control over their bodies and lives.

It is clear, governments and communities are failing women and girls. There are few sustainable solutions that enable women and girls to protect themselves from HIV, violence and poverty. This is grossly unacceptable, particularly because the world can do much better.

Empowered women and girls are critical agents of change in reversing the epidemic. If society invests in the health of women and girls, it is possible for them to have the future they want.

This is why UNAIDS prioritizes gender equality and why UNAIDS is calling for zero tolerance for violence. Together, we will reach the future we want: zero new HIV infections, zero discrimination and zero AIDS-related deaths among women and girls.

WHO recommendations related to use of hormonal contraceptives remain unchanged. The use of condoms—male and female—is a reliable method of HIV prevention.

GENEVA, 16 February 2012—A stakeholder consultation convened by the World Health Organization (WHO) in Geneva has reviewed recent epidemiological studies related to HIV transmission and acquisition by women using hormonal contraceptives. After careful review of all available evidence, the stakeholders found that the data were not sufficiently conclusive to change current guidance.

In light of this review, WHO today announced that its current recommendation­­—no restrictions on the use of hormonal contraceptives to avoid unintended pregnancies—remains unchanged. They also recommend that women using progestogen-only injectable contraceptives also use condoms or other measures to prevent HIV infection. This information must be communicated to sexually active women and girls by health workers pro-actively.

About half of the 34 million people living with HIV are women. In sub-Saharan Africa, the region most affected by the epidemic, nearly 60% of all new HIV infections occur in women.

The level of unmet family planning need among the 1.18 billion women aged 15–49 worldwide is estimated to be 11%. Among the 128 million women (married or in a union) aged 15–49 in sub-Saharan Africa, the estimated unmet need for family planning is more than twice as high, at 25%. This highlights the urgency of finding innovative solutions that address the dual needs of women in preventing HIV and stopping unintended pregnancies.

While a range of contraceptives protect against unintended pregnancies, only condoms, male and female, provide dual protection by stopping HIV transmission and preventing unintended pregnancies.  

The Joint United Nations Programme on HIV/AIDS (UNAIDS) recommends that people who are sexually active—particularly women and girls—have full access to information and counselling to make evidence informed choices about their sexual and reproductive health needs. Women and girls must also have access to the widest range of contraceptive and HIV prevention options. Such services must be provided in an integrated manner by health workers.

The lack of female controlled methods of HIV prevention and low levels of condom use place women and girls at increased vulnerability to HIV infection. “Women need safe contraceptive and HIV prevention options that they can own and manage,” said Michel Sidibé, Executive Director of UNAIDS. “New investments into research for female controlled HIV prevention options and safe contraceptive methods are essential.”

From left to right: UNAIDS Executive Director Michel Sidibé, former president of Botswana, Mr Festus Gontebanye Mogae, Ambassador Eric Goosby, United States Global AIDS Coordinator call for accelerated access to voluntary medical male circumcision in eastern and southern Africa, at ICASA 2011. 5 December 2011.
Credit: UNAIDS/ P. Wiggers

ADDIS ABABA, 5 December 2011—The Joint United Nations Programme on HIV/AIDS (UNAIDS) and the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) today launched a five-year action framework to accelerate the scale-up of voluntary medical male circumcision (VMMC) for HIV prevention. The framework—developed by the World Health Organization (WHO), UNAIDS, PEFPAR, the Bill & Melinda Gates Foundation and the World Bank in consultation with national Ministries of Health—calls for the immediate roll-out and expansion of VMMC services in 14 priority countries of eastern and southern Africa.

“Voluntary medical male circumcision is a high-impact and cost-effective prevention tool that will bring us one step closer to our goal of an HIV-free generation," said UNAIDS Executive Director Michel Sidibé, who unveiled the action framework at the 16th International Conference on AIDS and STIs in Africa (ICASA), together with partners. “Each HIV infection averted is money in the bank and fiscal space for the future,” he added. Joining Mr Sidibé at the launch in Addis Ababa, Ethiopia, were the U.S. Global AIDS Coordinator Dr Eric Goosby and the former President of Botswana, Festus Mogae.

There is compelling evidence that VMMC, when provided by well-trained health professionals, reduces the risk of sexual transmission of HIV from women to men by approximately 60 per cent. Since 2007, WHO and UNAIDS have urged countries with high HIV prevalence and low levels of male circumcision to expand access to safe VMMC services.

VMMC offers excellent value for money. Recent modelling commissioned by PEPFAR and UNAIDS found that reaching 80% coverage of adult VMMC in the 14 priority countries would entail performing approximately 20 million circumcisions on men aged 15-49 by the year 2015. Such a scale-up would cost a total of US$1.5 billion and would result in a net savings of US$16.5 billion by 2025 due to averted treatment and care costs. An estimated 3.4 million new HIV infections would be averted through 2025.

To date, the scale-up of VMMC has been modest in most countries. According to the joint framework, more than 550 000 men aged 15-49 had been circumcised in the 14 priority countries by the end of 2010. The greatest success in scaling up adult VMMC has occurred in Kenya, particularly in Nyanza Province. While progress in implementing VMMC programmes has been more limited in the other priority countries, nearly all countries saw the pace of scale-up quicken in 2010.

Acknowledging the important role of country ownership and accountability in health systems, U.S. Global AIDS Ambassador Dr Eric Goosby stated, “PEPFAR strongly supports heightened and immediate national ownership in all priority countries to implement safe, efficient voluntary medical male circumcision scale-up strategies. VMMC offers men an unprecedented opportunity to assume a proactive role in reducing their risk of contracting HIV, empowering them to protect their health and the health of their partners."

The new framework proposes strategic and coordinated action among partners at local, national and global levels to harness resources and focus on reaching adult and adolescent men with VMMC services as quickly and safely as possible. It underscores that country leadership is critical to the success and sustainability of this initial phase of VMMC programmes. The longer-term goal is to offer VMMC for all infants in the priority countries—replacing the need for adolescent and adult VMMC.

Innovation in service delivery, supply chain logistics, human resource deployment and medical devices is encouraged to improve efficiency, access, and safety, while creating demand for VMMC services. The framework urges governments in the 14 priority countries to seek funding from a range of domestic and international sources—with a view, over time, to a greater reliance on national on and local resources.

Speaking at today’s press briefing, Mr Festus Mogae called on leaders to support and scale up VMMC programmes in the 14 priority countries. “Strong collaboration between political, traditional and religious leadership will be critical to the safe and effective scale up of VMMC services,” said Mr Mogae, who is the chairman of Champions for an HIV-Free Generation, a non-governmental organization. “The key role of religious and traditional leaders is to ensure that there is a working partnership with the communities so that while the circumcision is done medically as an add-on HIV prevention strategy, it still retains its religious or cultural significance to the communities,” he added.

VMMC is an important component of a comprehensive HIV prevention package. WHO, UNAIDS and PEPFAR recommend a combination approach to HIV prevention that includes the correct and consistent use of male and female condoms; treatment for sexually transmitted infections; the promotion of safer sexual practices such as avoidance of penetrative sex; the provision of antiretroviral therapy for HIV-positive people who are eligible for treatment; and voluntary medical male circumcision in certain settings. 

VMMC is a life-saving HIV intervention with major cost benefits. A one-time health intervention, VMMC confers life-long partial protection against HIV. The joint framework launched today embraces urgent and widespread scale-up of VMMC in all priority countries through a coordinated, country-driven effort.

China calls for shared responsibility in achieving zero new HIV infections, zero discrimination, zero AIDS-related deaths

UNAIDS Executive Director Michel Sidibé and China’s Premier H.E. Wen Jiabao at a World AIDS Day event in Beijing.

BEIJING/GENEVA, 1 December 2011—China has pledged to fill its HIV resource gap by increasing domestic investments. This pledge was made China’s Premier H.E. Wen Jiabao at a World AIDS Day event in Beijing. The Premier also called on the international community to fully meet its commitments and achieve a world with zero new HIV infections, zero discrimination and zero AIDS-related deaths.

“I see no reason for the Global Fund to withdraw its support to China,” said Premier Wen Jiabao at the AIDS roundtable in Beijing. “I have asked the Minister of Finance to close the gap left by the Global Fund. We will rely on our own efforts.”

This new commitment from China comes at a crucial moment as resources for AIDS are declining and the Global Fund to Fight AIDS, Tuberculosis, and Malaria is facing a major setback in resource mobilization, leading to the cancellation of its next call for country proposals (Round 11), putting millions of lives at risk. 

"China's voice could not have come at a more critical time in the AIDS response. We are in a period of high risk and welcome this bold decision," said Michel Sidibé, Executive Director of UNAIDS, when thanking the Premier of China. "I am confident that a new socially sustainable agenda can be forged that promotes country ownership and shared responsibility.”

More than 6.6 million people are on HIV treatment in low- and middle-income countries and rates of new HIV infections have fallen in most parts of the world. Domestic investments have steadily increased, but the magnitude of the epidemic in Africa means that continued international solidarity and investments are vital.

“Getting Round 11 back on track is a top priority especially as Africa is leading the world in reducing new HIV infections and AIDS-related deaths. Its international partners must come forward and help countries multiply their success,” said Mr Sidibé. “This call is not just about shared responsibility but also of shared values.”

China has scaled up its AIDS response in a short timespan, including its evidence-informed HIV prevention services. By rapidly scaling up access to drug substitution therapies, it has reduced new HIV infections among people using these services to close to zero. China has also made important advances in its anti-discrimination programmes and support for civil society organizations. 

“To defeat AIDS, it will take the whole society,” said Premier Wen Jiabao. “China is willing to play its part.” China’s rapid scale up model can be replicated in other countries—especially in strengthening the capacity of community health workers to deliver HIV services. In addition, China can provide vital technology transfer in key areas of innovation of HIV treatment, including development of new antiretroviral medicines, investing in research and development, telecommunications, e-health infrastructure and supply chain management.

Korean footballer Myung-Bo Hon with the UNAIDS Executive Director Michel Sidibé. Seoul, 28 November 2011.

SEOUL, Republic of Korea, 28 November 2011— Iconic Korean football star, Myung-Bo Hong, was appointed as a UNAIDS International Goodwill Ambassador during a press conference held at Yonsei University in Seoul. In this capacity, Myung-Bo Hong will raise awareness on HIV prevention among young people and help break down the barriers of stigma and discrimination surrounding HIV, particularly within the Republic of Korea and across Asia.

“As one of the greatest Asian football players of all time, Myung-Bo Hong will be a compelling advocate on HIV prevention for young people and football fans worldwide,” said Michel Sidibé, UNAIDS Executive Director. “I am honoured UNAIDS will work with such an inspiring athlete to disseminate vital messages about HIV to young people.”

“Accelerated efforts are needed on HIV to ensure zero new HIV infections, zero discrimination and zero deaths,” said Mr Byeongleul Jun, Director of the Korean Centre for Disease Control and Deputy Minister of Health and Welfare. “The involvement of a sporting hero as great as Myung-Bo Hong can greatly advance this important agenda and make a difference in the AIDS response around the world,” he said.

Myung-Bo Hong joins prominent individuals from the world of arts, science, literature, entertainment as an advocate for zero new HIV infections and zero discrimination. Other UNAIDS Goodwill Ambassadors include Naomi Watts, Annie Lennox, and Michael Ballack.

“People living with HIV are people like you and me,” said Myung-Bo Hong during the appointment ceremony. “They have rights and should not be discriminated against. I am delighted to be working with UNAIDS to use sport to help bring an end to AIDS.”

Currently Korea’s National Olympic Football Team Manager, Myung-Bo Hong, played for the country’s national football team in four consecutive World Cups (1990-2002) and was chosen among the “FIFA 100”, a selection of the 125 greatest living footballers in the world made by Brazilian football legend Pelé. He was the first Asian footballer to receive FIFA’s World Cup Bronze Ball in 2002.

“We are very glad UNAIDS has recognized Myung-Bo Hong as both a sports celebrity and a prominent humanitarian. Mr. Hong has established a great level of influence in football worldwide, and his appointment as the UNAIDS Goodwill Ambassador has great potential to make a critical push against HIV infections and discrimination,” said Mr Soo-Gil Park, President of World Federation of United Nations Associations.

Globally there are more than 5 million young people living with HIV and every day 2400 young people become infected with the virus. Although young people are increasingly learning how to protect themselves, only one-third of young people globally have accurate and comprehensive knowledge of how to protect themselves from HIV.

Substantial scale up, even during the financial crisis, highlights country driven commitments—new investment framework will help countries save more lives and money

L to R: German Federal Minister of Health (BMG), Daniel Bahr, UNAIDS Executive Director Michel Sidibé, German Federal Minister for Economic Cooperation and Development (BMZ), Dirk Niebel.
Photo credit: UNAIDS/ C. Koall

BERLIN/GENEVA, 21 November 2011—A new report by the Joint United Nations Programme on HIV/AIDS (UNAIDS), released today shows that 2011 was a game changing year for the AIDS response with unprecedented progress in science, political leadership and results. The report also shows that new HIV infections and AIDS-related deaths have fallen to the lowest levels since the peak of the epidemic. New HIV infections were reduced by 21% since 1997, and deaths from AIDS-related illnesses decreased by 21% since 2005.

“Even in a very difficult financial crisis, countries are delivering results in the AIDS response.” said Michel Sidibé, Executive Director of UNAIDS. “We have seen a massive scale up in access to HIV treatment which has had a dramatic effect on the lives of people everywhere.”

According to UNAIDS and WHO estimates, 47% (6.6 million) of the estimated 14.2 million people eligible for treatment in low- and middle-income countries were accessing lifesaving antiretroviral therapy in 2010, an increase of 1.35 million since 2009. The 2011 UNAIDS World AIDS Day report also highlights that there are early signs that HIV treatment is having a significant impact on reducing the number of new HIV infections.

In Botswana, patterns in sexual behaviour have remained relatively stable since 2000. The country scaled up access to treatment from less than 5% in 2000 to over 80% which it has maintained since 2009. The annual number of new HIV infections has declined by over two thirds since the late nineties and data suggests that the number of new HIV infections in Botswana is 30% to 50% lower today than it would have been in the absence of antiretroviral therapy. As treatment reduces the viral load of a person living with HIV to virtually undetectable levels, it also reduces the risk of transmitting the virus to an uninfected partner. Recent studies show that treatment can be up to 96% effective in preventing HIV transmission among couples.

At the end of 2010 an estimated:

• 34 million [31.6 million – 35.2 million] people globally living with HIV
• 2.7 million [2.4 million – 2.9 million] new HIV infections in 2010
• 1.8 million [1.6 million – 1.9 million] people died of AIDS-related illnesses in 2010

Treatment has averted 2.5 million deaths since 1995

People living with HIV are living longer and AIDS-related deaths are declining due to the lifesaving effects of antiretroviral therapy. Globally there were an estimated 34 million people [31.6 million – 35.2 million] living with HIV in 2010, and since 2005, AIDS-related deaths decreased from 2.2 million [2.1 million – 2.5 million] to 1.8 million [1.6 million – 1.9 million] in 2010. Around 2.5 million deaths are estimated to have been averted in low- and middle-income countries due to increased access to HIV treatment since 1995.

Progress in HIV prevention

New HIV infections have been significantly reduced or have stabilized in most parts of the world. In sub-Saharan Africa the number of new HIV infections has dropped by more than 26%, from the height of the epidemic in 1997, led by a one third drop in South Africa, the country with the largest number of new HIV infections in the world.

In the Caribbean, new HIV infections were reduced by a third from 2001 levels—and by more than 25% in Dominican Republic and Jamaica. Similarly the number of new HIV infections in South and South-East Asia dropped by more than 40% between 1996 and 2010. In India new HIV infections fell by 56%.

However, the number of new HIV infections continues to rise in Eastern Europe and Central Asia, Oceania and Middle-East and North Africa, while it has remained stable in other regions of the world.

Declines in new HIV infections are also being spurred by changes in sexual behaviour, particularly in young people, as people reduce their numbers of sexual partners, increase condom use and are waiting longer before becoming sexually active. HIV prevalence declined among young people in at least 21 of 24 countries with national HIV prevalence of 1% or higher. Five additional countries, Burkina Faso, Congo, Ghana, Nigeria, and Togo have seen HIV prevalence decline by more than 25% between 2001 and 2010 among young people.

The rate of new HIV infections in urban Zimbabwe fell from almost 6% in 1991 to less than 1% in 2010. Without changes in behaviour, studies estimate that there would have been an additional 35 000 new infections annually.

The report highlights that an increase in uptake of male circumcision is also starting to contribute to declines in new HIV infections. Studies show that 2000 new HIV infections were averted among men in Kenya’s Nyanza province after scale up of voluntary male circumcision. Estimates in the report highlight that circumcising 20 million more men across Eastern and Southern Africa would avert around 3.4 million new HIV infections by 2015.

Around 400 000 new HIV infections in children are estimated to have been averted since 1995 due to increased access to effective antiretroviral regimens in low- and middle income countries by 2010, almost half (48%) of all pregnant women living with HIV were able to access effective regimens to prevent their child from becoming infected with the virus.

Smarter investments to deliver a better package

UNAIDS has mapped a new framework for AIDS investments which are focused on high-impact, evidence-based, high-value strategies.

"The investment framework is community driven not commodity driven. It puts people at the centre of the approach, not the virus," said Mr Sidibé.

This new strategic approach to investments would achieve extraordinary results; at least 12.2 million new HIV infections would be averted, including 1.9 million among children between 2011 and 2020; and 7.4 million AIDS-related deaths would be averted between 2011 and 2020.

The framework is based on six essential programme activities: focused interventions for key populations at higher risk (particularly sex workers and their clients, men who have sex with men, and people who inject drugs); prevention of new HIV infections in children; behaviour change programmes; condom promotion and distribution; treatment, care and support for people living with HIV; and voluntary medical male circumcision in countries with high HIV prevalence.

For the framework to be effective, programme activities must recognise critical enablers, such as reducing stigma, respect for human rights, creating a protective legal environment and capacity building for community based organizations, which are crucial to overcoming the barriers to successful programme outcomes.

Using the framework to achieve universal access to HIV prevention, treatment, care and support by 2015 requires a scaling up of funding to US$ 22-24 billion in 2015, in line with the targets in the 2011 United Nations Political Declaration on HIV/AIDS. If full implementation of the new framework is achieved in the next four years, global resource needs would peak in 2015 and decline gradually thereafter; making the AIDS response an excellent investment opportunity where returns will offset the upfront cost in less than one generation.

At the end of 2010 around US$ 15 billion was available for the AIDS response in low- and middle-income countries. Donor funding has been reduced by 10% from US$ 7.6 billion in 2009 to US$ 6.9 billion in 2010. In a difficult economic climate the future of AIDS resourcing depends on smart investments.

To rapidly reduce new HIV infections and to save lives, the 2011 UNAIDS World AIDS Day report underscores that shared responsibility is needed.

WASHINGTON D.C./GENEVA, 8 November 2011—The Joint United Nations Programme on HIV/AIDS (UNAIDS) commends the United States Government on its continued leadership in the AIDS response following the call by the US Secretary of State Hillary Rodham Clinton for global solidarity to “change the course of the epidemic and usher in an AIDS-free generation”.

“Leadership from the United States has been vital to the AIDS response to date and will be key to seizing this historic opportunity,” said Michel Sidibé, Executive Director of UNAIDS. “Secretary Clinton has reaffirmed the United States’ Government’s strong commitment to this effort and has described a vision that should inspire us all. I hope that her call will galvanize leadership from around the globe to accelerate efforts to end the AIDS epidemic.”

In her speech, the US Secretary of State outlined the far-reaching impact of scaling up scientifically proven prevention strategies in combination with new and emerging developments in HIV science and research. These strategies include: elimination of new HIV infections among children, increased voluntary medical male circumcision, and expanded access to treatment.

Earlier this year UNAIDS highlighted the significance of the recent research demonstrating that people who access treatment early can reduce their likelihood of transmitting HIV to a partner by 96%. The potential impact of treatment for prevention will change attitudes, connect communities and motivate millions of people find out their HIV status and to talk openly with their partners about HIV.

To achieve an AIDS-free generation, the US Secretary of State reiterated UNAIDS’ call for greater engagement and investment in the global AIDS response by both donor and recipient countries.

UNAIDS underlines the importance of shared responsibility in the AIDS response. Shared responsibility is one of the central pillars of UNAIDS’ strategy to reach zero new HIV infections, zero discrimination and zero AIDS-related deaths by 2015.

UNAIDS is already working closely with PEPFAR and other partners around the world to achieve the ambitious goals UN member states committed to in the 2011 Political Declaration on HIV/AIDS. Achieving these goals will bring the world one step closer to an AIDS-free generation.

UNAIDS will use crowdsourcing technologies and social media platforms to engage young people in developing AIDS policy

GENEVA, 25 October 2011—The Joint United Nations Programme on HIV/AIDS (UNAIDS) is launching CrowdOutAIDS.org, an online collaborative project to crowdsource its new strategy on youth and HIV—a first in the UN system.

Crowdsourcing is a technique used to rapidly engage large numbers of interested people to develop strategies, solve problems or propose relevant and fresh ideas. With around 3000 young people aged 15-24 becoming infected with HIV daily, leveraging new modes of communication and online collaboration with young people is essential for an effective response to HIV.

“We’re asking youth around the world to debate, draft and work with UNAIDS to implement this new strategy,” said Michel Sidibé, Executive Director of UNAIDS. “It is absolutely critical that we engage young people—not as recipients of our messages but as the actors and creators of change.”

CrowdOutAIDS.org is a completely new way for UNAIDS to develop policy on HIV. It will use crowdsourcing technologies and familiar online tools such as Facebook, Twitter and Renren to ensure youth engagement and action in the AIDS response.

CrowdOutAIDS.org follows a four-step model and is open to anyone aged 15-29. Young people will be able to shape the new strategy from conceptualization to final drafting via a wiki-platform.

“It is important to involve young people in policy development in order for our views, expectations and aspirations to be fully represented,” said Jennifer Ehidiamen, a blogger and journalist from Nigeria, and online content curator for CrowdOutAIDS.org. “CrowdOutAIDS.org is an innovative way to build a strong community, interested in sharing solution-based ideas and actions on AIDS.”

The project will run over a period of two months with the final crowdsourced strategy being produced in January, 2012. To find out more, visit www.CrowdOutAIDS.org, and follow @UNAIDS and #CrowdOutAIDS on Twitter.

ROME/GENEVA, 20 July 2011—The Joint United Nations Programme on HIV/AIDS (UNAIDS) strongly welcomes new results confirming that scaling-up adult male circumcision works to prevent HIV in men. The study, which was carried out in the township of Orange Farm in South Africa, resulted in a 55% reduction in HIV prevalence and a 76% reduction in HIV incidence in circumcised men.

The results were announced today in Rome at the 6th IAS Conference on HIV Pathogenesis, Treatment and Prevention by the French National Agency for Research on AIDS and Viral Hepatitis. It is the first time a study has shown that male circumcision roll-out is effective at community level in preventing HIV.

“Science is proving that we are at the tipping point of the epidemic,” said Michel Sidibé, Executive Director of UNAIDS. “Urgent action is now needed to close the gap between science and implementation to reach the millions of people who are waiting for these discoveries. Scaling up voluntary medical male circumcision services rapidly to young men in high HIV prevalence settings will help reach the 2015 goal of reducing sexual transmission of HIV by 50%.”

During the study, free circumcision services offered to all men over 15 years of age resulted in 20 000 circumcisions over a three-year period.  From 2007 to 2010 the percentage of circumcised men increased from 16% to 50% among men between the ages of 15 and 49 years, peaking at 59% in young men aged 15 to 24 years. Community-based surveys reveal no changes in sexual behaviour. The total population of the township of Orange Farm is estimated to be around 110 000.

Many African countries are strongly supporting the scale-up of male circumcision. Kenya has taken the lead, providing voluntary male circumcision to 290 000 men over the past three years, mostly in the province of Nyanza. As reported today at the Rome conference, the men who were circumcised did not increase their risk behaviour. In Tanzania, where the government announced plans to circumcise at least 2.8 million men and boys between the ages of 10 and 34 over a five-year period, a rapid results campaign in early 2011 saw more than 10 000 boys and men circumcised over six weeks.

His Majesty King Mswati III of Swaziland, together with the Swazi Ministry of Health and the US President’s Emergency Plan for AIDS Relief, has recently launched a plan to provide voluntary medical male circumcision to the 152 800 men living in Swaziland between the ages of 15-49 years. Swaziland has the highest HIV prevalence rate in the world, estimated at 26% of adults aged 15-49 years. A statement released by the US Embassy in Swaziland estimated that the circumcision plan could avert nearly 90,000 new HIV infections and save more than US$ 600 million over the next decade.     

These results and announcements follow other recent scientific breakthroughs in HIV prevention: the HPTN 052 trial announced in May showed that early initiation of antiretroviral therapy can reduce the risk of transmission to an uninfected partner by 96%; the Partners PrEP and TDF2 studies announced last week show that a daily antiretroviral tablet taken by people who do not have HIV infection can reduce their risk of acquiring HIV by up to 73%; in November 2010, the iPrEx trial among men who have sex with men reported a 44% reduction in HIV acquisition among HIV negative men who took a daily antiretroviral tablet; and the CAPRISA gel study results announced in July 2010 showed that an antiretroviral gel—when used as a vaginal microbicide—was 39% effective in reducing a woman’s risk of becoming infected with HIV during sex.

UNAIDS stresses that despite the recent scientific discoveries there is still no single method which is fully protective against HIV. To reach UNAIDS vision of Zero new HIV infections, UNAIDS strongly recommends a combination of HIV prevention options. These include correct and consistent use of male and female condoms, waiting longer before having sex for the first time, having fewer partners, medical male circumcision, avoiding penetrative sex and ensuring that as many people as possible in need of antiretroviral therapy have access to it.

New data from studies in Kenya, Uganda and Botswana confirm major role of antiretroviral medicine in preventing heterosexual HIV transmission

GENEVA, 13 July 2011—Results announced today from two studies reveal that a daily antiretroviral tablet taken by people who do not have HIV infection can reduce their risk of acquiring HIV by up to 73%. Both daily tenofovir and daily tenofovir/emtricitabine taken as preventive medicine (PrEP - pre-exposure prophylaxis) can prevent heterosexual transmission of HIV from men to women and from women to men.

The Partners PrEP trial, conducted by the University of Washington’s International Clinical Research Center, followed 4758 sero-discordant couples (in which one person had HIV infection and the other did not) in Kenya and Uganda. Couples received counselling and free male and female condoms. The uninfected partner took a once-daily tenofovir tablet or a tenofovir/emtricitabine tablet or a placebo pill. There were 62% fewer HIV infections in the group receiving tenofovir and 73% fewer HIV infections in the group that took tenofovir/emtricitabine than in the group receiving the placebo.

The TDF2 trial, conducted by the United States Centers for Disease Control, followed 1200 men and women in Botswana who received either a once-daily tenofovir/emtricitabine tablet or a placebo pill. The antiretroviral tablet reduced the risk of acquiring HIV infection by roughly 63% overall in the study population of uninfected heterosexual men and women.

“This is a major scientific breakthrough which re-confirms the essential role that antiretroviral medicine has to play in the AIDS response,” said Michel Sidibé, Executive Director of the Joint United Nations Programme on HIV/AIDS (UNAIDS). “These studies could help us to reach the tipping point in the HIV epidemic.”

The medicines are available generically in many countries at prices as low as US$ 0.25 per tablet. In November 2010, the iPrEx trial among men who have sex with men in six countries reported a 44% reduction in HIV transmission among those who took a daily tenofovir/emtricitabine tablet.

“Effective new HIV prevention tools are urgently needed, and these studies could have enormous impact in preventing heterosexual transmission,” said Dr Margaret Chan, WHO's Director-General. “WHO will be working with countries to use the new findings to protect more men and women from HIV infection.”

UNAIDS and WHO have already been working with countries in sub-Saharan Africa, Latin America and Asia to explore the potential role of pre-exposure prophylaxis in HIV prevention. This news will encourage more people to get tested for HIV, discuss HIV prevention options with their partners and access essential HIV services.

It is currently estimated that only about half of the 34 million people living with HIV know their HIV status. An increase in the uptake of testing for HIV would have a significant impact on the AIDS response, particularly if more people gain access to new HIV prevention technologies in light of the new findings.

UNAIDS and WHO recommend that individuals and couples make evidence-informed decisions on which combination of HIV prevention options is best for them. No single method is fully protective against HIV. Antiretroviral drugs for prevention need to be combined with other HIV prevention options. These include correct and consistent use of male and female condoms, waiting longer before having sex for the first time, having fewer partners, medical male circumcision and avoiding penetrative sex.