Small group counseling. In one study, none of the couples who consistently used condoms seroconverted. Many characteristics of successful HIV prevention programs hold true across populations. Intense interventions that are sustained over time are more likely to produce long-term behavior change. Improving access to devices necessary for safer practices, such as clean needles and condoms, is crucial.
Skills building and modifying community norms are essential program elements.
Timing of HIV prevention messages is important, as demonstrated with adolescent programs, where providing explicit prevention education before the time they are sexually active can have a greater impact than education after the initiation of sexual activity. Programs addressing discordant couples are especially effective in groups with high prevalence of HIV infection. A comprehensive HIV prevention strategy uses multiple elements to protect as many people at risk for HIV as possible. We should learn from and promote the effectiveness of HIV prevention programs already in place, as well as continue to evaluate these programs. Finally, funding for prevention programs and research into prevention science needs to be tied to effectiveness and public health importance.