Utilizing HIV transmission rates to assist in prioritizing HIV prevention services.

The overall, annual HIV transmission rate in the US has been about 4% since the early 1990s. In this paper, we find that the transmission rate for persons unaware of their HIV serostatus is approximately 10.79%, and for persons aware of their HIV seropositivity is about 1.73% overall. However, the latter statistic can be further disaggregated. For persons who receive HIV counselling and testing, and for whom these services are effective, the transmission rate is near 0%. For persons who do not receive counselling services as well as testing, or for whom counselling and testing is insufficient to induce behavioural change, the HIV transmission rate is between approximately 2% and 4%. These estimated transmission rates, as well as the raw number of transmissions and the specific population sizes examined here, suggest some clear recommendations (provided here) for prioritizing HIV prevention services for persons living with HIV.

Barcelona 2002: law, ethics, and human rights. An advocacy and political conference produces a consensus: effective action is urgently required.

From the deep sense of frustration about the gap between what is possible and what is actually happening, a clear consensus emerged at the XIV International AIDS Conference that effective action is urgently required. This article is based on a presentation on 12 July 2002, the last day of the conference, by Terje Anderson, the rapporteur for Track G. The article presents a summary of the discussions in Track G on topics such as advocacy strategies, the use of the law, the use of a human rights framework and approach, the role of people living with HIV/AIDS, and the need to mobilize sufficient resources. The article states and then critically examines some of the consensus positions that emerged from the conference--specifically, the goal to have three million people on antiretroviral therapy by 2005; the notion that the debate around prevention versus care is over; and the idea that the key issue is no longer what we do, but how to secure the commitment and the resources to do it. The article states that the fight against HIV/AIDS must be fought on a political plane, and that it is the responsibility of everyone working in AIDS to engage our leaders. The article concludes by asking whether we really have the courage and the perseverance to turn our knowledge and our commitment into action.