This chapter discusses the combination of interventions to stop the spread of HIV—in other words “combination prevention.” Combination prevention requires simultaneous action on several fronts. This includes condom use, behavioral change toward fidelity and fewer sex partners, smaller age differences between partners, male circumcision in high-prevalence countries, antiretroviral therapy including pre-exposure prophylaxis (PrEP), harm reduction through substitution therapy and access to clean needles and syringes for injecting drug users, structural interventions against sexual violence and alcohol abuse, and countering HIV-related stigma. Each specific epidemiological situation should be addressed through an optimal combination of interventions. While the concept of combination prevention is not new in public health or social programs, it has been less popular in infectious disease control. For example, anti-smoking and obesity campaigns are using it. A key question for HIV prevention is the effectiveness of various combinations for a given risk situation, and more research is needed in this area.
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