Positive Prevention: An Overview
In the last several years, HIV prevention efforts have increased their focus on people living with HIV and AIDS (PLHA) in addition to addressing risk reduction efforts aimed at HIV-uninfected individuals. The Advancing HIV Prevention Initiative sponsored by the U.S. Centers for Disease Control and Prevention (CDC) further highlighted the need to work with PLHA as a key strategy for decreasing the steady rate of new HIV infections in the United States and abroad (CDC 2003). These interventions, often known as Prevention with Positives (PWP) or Positive Prevention (PP), and more recently as Positive Health, Dignity, and Prevention (GNP+ 2009), provide services for PLHA to address HIV care and prevention needs and to ultimately decrease HIV transmission risk behavior. PP programs ensure that the opportunity to address HIV prevention with infected individuals is not missed.
The advent of antiretroviral therapy (ART) and the subsequent improvement it brought to the health and quality of life for PLHA has had a profound impact on the needs of PLHA. Increasingly, PLHA were living longer, feeling better, and seeking to resume normal lives in their communities that included sexual relationships, having children, and pursuing their personal goals. The introduction of ART precipitated a paradigm shift in HIV counseling and messages needed to focus more on reducing risk, preventing the spread of HIV, and living normal, healthy lives. The needs of HIV-infected individuals must be addressed in a meaningful way as PLHA take more control of their treatment and address their health in new ways.
In time, PLHA have become an outspoken group working for equal treatment and understanding in their communities and their societies, and they are at the forefront of HIV prevention efforts. PLHA now recognize the power they have to address HIV infection and their strength to support one another and disseminate information to their communities. The future direction of the HIV epidemic will depend on PLHA and their ability to make positive behavior changes that will contribute to reducing the rate of HIV transmission.