Publications

In the United States, HIV prevention services are increasingly being offered in the context of healthcare settings. This includes prioritizing prevention services for people living with HIV (PLWH), otherwise known as "prevention with positives." We conducted sixty in-depth interviews to explore patients' perceptions of clinic-based HIV prevention interventions targeting people living with HIV. The majority of patients were receptive to the prevention interventions. Patients described experiencing feeling fulfilled by communicating about issues related to HIV prevention when the conversations were specific to their situation and with an interventionist who was objective, yet empathic and non-judgmental. Provider-delivered interventions opened up new areas of prevention discussions with patients. Specialist-delivered interventions, specifically group-level interventions, provided opportunities to integrate participants into social networks that in turn provided social support and a reduction in social isolation. HIV prevention counseling benefited patients regardless of risk status.

Scientific innovation and research advances have enabled significant progress toward what President Obama and Secretary Clinton have described as an AIDS-free generation. Over the past decade, the United States, through the President's Emergency Plan for AIDS Relief, has played a key role in laying the foundation for this goal. However, the global AIDS response is a shared responsibility that must be met by the global community. This article explores key questions to guide global partners' efforts in maximizing the impact of bilateral, multilateral, and partner country investments. To inform decision-making, make smart investments and support country ownership of programs, areas of analysis should include the following: the use of economic and financial data to understand expenditures; allocation of resources based on scientific evidence of impact; opportunities for collaboration with governments, the Global Fund and others to align programs; and streamlining of business processes to maximize impact. President's Emergency Plan for AIDS Relief has applied this analysis in planning expansion of antiretroviral treatment programs, allowing investments to be tailored to country circumstances-a key to making smart investments and increasing the number of lives saved with the resources given.