While the principal
work of the HIV Center is to conduct research,
our investigators also periodically publish
commentaries on "big picture" issues that are
shaping the course of the AIDS epidemic. This
spring, HIV Center investigators
published commentaries in top-tier
journals on two cutting-edge topics in HIV
prevention.
In a commentary entitled "Going Beyond ‘ABC' to
Include ‘GEM': Critical Reflections on Progress
in the HIV/AIDS Epidemic," investigator
Shari Dworkin,
Ph.D. and Center
 Director
Anke
Ehrhardt, Ph.D. argued for the need to move past limited,
individual-focused ABC ("abstinence, be
faithful, condom use") strategies to include
gender, economics and migration (GEM),
particularly in light of the growing numbers of
HIV-positive women. The commentary was
published in the
American Journal of Public
Health, January 2007, Vol. 97, No. 1.
"In the third decade of the epidemic it remains vital
to not just emphasize how individuals need to
change and maintain their own behaviors," the
authors wrote. "Rather, we must also emphasize
how successful prevention strategies need to
take into account gender relations, other
relations of social inequality, economic
contexts, and migration movements. |
"These strategies will best sustain behavioral
changes in the contexts that drive risk.
The breadth and the maintenance of success rely
on united work in these areas. The new face of
the epidemic speaks strongly to the urgency of
these efforts." This
spring, Dworkin also co-authored a Viewpoint
article on "Male Circumcision and HIV/AIDS:
Challenges and Opportunities" responding to
early results from an NIH study in Kenya and
Uganda that male  circumcision provided slightly
more than a 50 percent protective benefit
against HIV transmission. The article,
co-authored with Sharif R. Sawires, M.A., Agnes
Fiamma, M.I.P.H., Dean Peacock, M.S.W., Greg
Szekeres, and Thomas J. Coates, Ph.D., was
published in
The Lancet, Vol. 369, February
24,
2007.
The article identifies 13 challenges and opportunities
presented by male circumcision, including
issues relating to acceptability,
communication, social impacts, and safety
considerations. "The challenges are not
intended to discourage the use of male
circumcision for HIV nor are they intended to
slow the development of potential
interventions," the authors state. "Rather, we
present these issues to ensure that the
discussion regarding the evolution and rollout
of male circumcision reflects the full range of
issues that should be considered for
individuals and for populations."
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