Incorporating a Structural Approach Within Combination HIV Prevention

By James R. Hargreaves

This paper proposes a three-pronged structural approach to be used by HIV prevention programmers: 1) social epidemiology targeting to enhance equity of HIV prevention, 2) interrupting the causal pathway from social determinants to risk through critical enabler interventions, and 3) addressing structural factors directly through HIV-sensitive, cross-sectoral development. This approach overlaps with the investment framework proposed by UNAIDS in 2011, which proposes three categories of investment required for a comprehensive response, namely: basic programmatic activities, addressing critical enablers and achieving development synergies. The author describes how a structural approach can inform action under all three headings.

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This paper is one of a series of five issue briefs on structural HIV prevention. To view the complete series, click here.