Essay on The Prevention of AIDS and HIV
AIDS prevention programs take two primary tacks: biomedical intervention and behavioral modification. Recommended biomedical interventions include securing the safety of blood and blood products, usually through the screening of donors; treating other sexually transmitted diseases that may increase the risk of HIV infection; and treating HIV-infected pregnant women with ARVs to reduce the risk of transmission to their children. A number of researchers are working to develop an AIDS vaccine, though that task is complicated by the rapid mutation of the virus and appears to be a number of years off. Another possible biomedical intervention would be the development of a microbicide--an agent capable of killing bacteria and viruses--that could be applied vaginally before sexual activity. Microbicides might have an advantage over condoms because they would allow women to assert greater control over their sexual safety, but their development has been given relatively little attention.
Behavioral intervention is used to modify the behaviors and practices of people to reduce the likelihood of transmission. Most behavioral interventions follow the ABC model: abstain, be faithful, use condoms. Prevention programs thus encourage people to wait longer to become sexually active, have fewer partners, and use condoms if they have multiple partners. The success of those programs has been highly variable. In societies in which resistance to or embarrassment about discussing sexual matters is common, it is difficult to improve knowledge and change attitudes on a wide scale and even more difficult to affect behavior substantially. Condoms are often unavailable or too expensive, and even in places where their use is fairly common, it appears to be highly inconsistent. Moreover, in extremely poor regions where expectations for future standards of living are low there may be little incentive to avoid AIDS. Although those populations may...
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