HIV/AIDS : the evolution of the pandemic, the evolution of the response

Already some 14 million people have been infected, and the World Health Organization (WHO) estimates that 30-40 million people, including millions of children, will have been infected by the year 2000, many of them in countries where the disease has yet to make its mark. USAID has assumed a leadership role in HIV/AIDS prevention, since 1986 supporting programs in 70 countries around the world, mostly through the centrally funded AIDSCOM and AIDSTECH projects, and in the process gaining insight into what works in such programs, i.e., peer education, aggressive condom marketing, multimedia campaigns, the development of simpler HIV diagnosis methods, attention to local sociocultural realities, and policy dialogue with host country leaders. USAID has applied this knowledge to the shifting patterns of the disease to refine its HIV/AIDS strategy, developing more comprehensive programs that integrate multiple interventions and address AIDS as a long-term problem, with activities concentrated in a limited number of countries. Increasingly, future Agency efforts will address the unique needs of women, integrate AIDS prevention into other health and development efforts, and explore innovative, research-based approaches to changing high-risk sexual behavior and prevent infection. The next 5 years hold the key to the success of such efforts. Appendices detail USAID"s prevention efforts by country. Funding levels for FY 1992 are also presented.