Searching for effective HIV-prevention in Sub-Saharan Africa: Focussing on local contexts

After nearly 20 years of experience with HIV prevention programmes, the number of people infected with HIV continues to rise, and there are still few examples of declining epidemics. Why have we not done better? This proposal is a response to the urgent n eed to document what works in concrete community HIV prevention programs. Effective HIV prevention will have to be guided by appropriate knowledge on the local epidemiological, cultural and socio-economic contexts, and many countries have restrained acces s to this type of knowledge. Moreover, the complexities involved in HIV prevention call for much stronger multidisciplinary efforts in research and development. The proposal accommodates five research components with a common focus on the generation of a ppropriate knowledge on local contexts to guide preventive efforts. There are sharp differentials in the dynamics and trends of HIV transmission within the region, and it has been important to cover such contrasts through the inclusion of different resear ch sites (Zambia, South Africa and Tanzania, Uganda). Besides having a general population approach, the project includes components targeting young people and the family. This includes the prevention of mother-to-child transmission and interventions relat ed to the community approaches to support orphans and the need to prevent exploitation, abuse and HIV transmission. The research proposals have been developed by an interdisciplinary group of researchers with longstanding experience from research related to the HIV-epidemic. They are involved as co-ordinators and researchers on several NUFU- and EU-funded projects in the field of HIV-prevention. Through these projects, an extensive network of researchers and institutions in sub-Saharan Africa and Europe has been established. The projects have a strong capacity building focus, and a substantial number of students from the South partners already enrolled in research training.