Everyone has a right to HIV prevention. Fulfilling that right begins with providing people who are at increased risk of HIV infection—includingyoung women and girls, and their male partners in sub-Saharan Africa, sex workers and their clients, gay men and other men who have sexwith men, people who inject drugs, transgender women, prisoners and people living with HIV—with access to effective, unhindered HIV prevention and treatment services. Everyone should be aware of HIV, and they should have the freedom to select and access prevention methods that fit their lives. For some, the right choice could be condoms; for others, it may be PrEP or adhering to antiretroviral therapy. For still others, it could be protection from violence and sexual abuse, or reducing their vulnerability—what matters is that they are empowered to take steps to protect themselves from HIV.
STRENGTH IN COMBINATION
There is no magic bullet for HIV prevention; only a combination of behavioural, biomedical and structural programmes and approaches will fully stop new HIV infections. Antiretroviral therapy and condoms are both more than 90% effective if used consistently, but on their own, they are unlikely to achieve the HIV prevention targets set. Neither can be successful without addressing the legal, policy, and other structural barriers to their use and adherence. Modelling shows that fully achieving the 90-90-90 treatment target is expected to avert about 60% of all new HIV infections by 2020. The remaining 40% of new HIV infections have to be averted through prevention methods, such as condoms, VMMC, harm reduction services (including opioid substitution therapy and needle–syringe programmes), PrEP, outreach to key populations, education and empowerment of young women and girls. When these (and other) HIV prevention services and tools are combined, the protective effect is much greater than the sum of the individual elements.