Federal officials say HIV prevention should target multiple sexual partnerships

Several federal officials and other AIDS experts say there "would be no global AIDS pandemic were it not for multiple sexual partnerships," and they urge HIV prevention programs to encourage people to reduce the number of sexual partners they have, according to an article by the officials in the April 10 issue of the British Medical Journal. The article was written by James Shelton, senior medical scientist for the U.S. Agency for International Development's Office of Population and Reproductive Health; Daniel Halperin, senior technical adviser for USAID's Office of HIV/AIDS; Vinand Nantulya, senior adviser for the Global Fund to Fight AIDS, Tuberculosis, and Malaria; Malcolm Potts, a University of California, Berkeley, population professor; Helene Gayle, director of HIV, Tuberculosis, and Reproductive Health for the Bill and Melinda Gates Foundation; and King Holmes, director of the University of Washington Center for AIDS and Sexually Transmitted Diseases. The article authors write that changing sexual behavior is the key to preventing the spread of HIV, particularly in developing nations where the virus is spread primarily through heterosexual contact. They write that HIV prevention programs should stress reducing casual sex and multiple sex partnerships as a way to protect oneself from HIV infection. While most HIV prevention programs stress abstinence and condom use as ways to prevent HIV transmissions, too little attention has been given to reducing numbers of sexual partners, they say, adding that it is "imperative to begin including (and rigorously evaluating) messages about mutual fidelity and partner reduction in ongoing activities to change sexual behavior.", "We have a public health responsibility to help people understand the strengths and limitations of each component and not promote one to the detriment of another," the authors conclude. "Rather than arguing over the merits of abstinence versus condoms, it is time for the international community to unite around a balanced, evidence-based ABC approach" that includes reductions in sexual partners as the "B" part of the three-step HIV prevention method that stresses: Abstinence, Be Faithful, Use Condoms.