In the past decade, the global strategy against AIDS has focused primarily upon prevention. Regardless of the effectiveness of prevention efforts being made today and advances in treatments, the numbers of persons infected globally continues to grow at an alarming rate, especially in developing countries. With numbers of infections increasing, and the trend to more people learning their HIV status earlier, demands for care will mount dramatically into the next century. This paper examines the virtually unexplored role care can play in prevention and its potential to have a mitigating effect on the pandemic. Critical issues addressed include (i) the relationship between care, HIV and productivity; (ii) the role of both care and prevention in promoting acceptance of HIV/AIDS as a community problem; (iii) the role of care in decreasing the vulnerability to HIV in specific populations such as women and children; (iv) the role of care in sustaining behavior change over time for infected persons; and (v) the synergy between improved treatments and prevention. Future areas of research are proposed examining these prevention and care issues that move beyond the traditional dichotomy.
PIP: The global strategy against AIDS over the past decade has focused mainly upon preventing the spread of HIV infection to additional populations and individuals. However, despite such prevention efforts and advances made in treatment, the number of people infected globally with HIV continues to grow at an alarming rate, especially in developing countries. The provision of care for HIV-infected people has historically not been viewed as a component of the overall strategy to reduce the incidence of HIV infection. However, HIV-infected people are important partners in preventing the spread of the virus. If they feel abandoned by care services, they may be less likely to understand the need for prevention and therefore less motivated to protect others. Demands for HIV/AIDS care will grow dramatically into the next century. The authors examine the largely unexplored role care can play in prevention and its potential to have a mitigating effect upon the pandemic. Main issues addressed include the relationship between care, HIV, and productivity; the role of care and prevention in promoting acceptance of HIV/AIDS as a community problem; the role of care in decreasing the vulnerability to HIV in populations such as women and children; the role of care in sustaining behavior change over time for infected persons; and the synergy between improved treatments and prevention. Future areas of research into prevention and care are proposed.