1. Office of Global Health and HIV (OGHH) Office of Overseas Programming & Training Support (OPATS) HIV Prevention Training Package Session 2: Combination Prevention

2. Session Learning Objectives  Participants identify all prevention activities prioritized by the health project framework and identify two appropriate activities and one inappropriate activity for PCVs.  Participants describe how biomedical, behavioral, and structural approaches interact to reinforce (or sometimes impede) HIV prevention efforts and work to achieve the “tipping point.”

3. Reduce new HIV infection to below ‘tipping point’

4. Combination prevention approaches  Biomedical – directly influence transmission of the virus  Behavioral – promote behaviors/practices that reduce risk of HIV infection and that increase demand for prevention services  Structural – address “enablers” in a community that may increase individual/ community risk for HIV infection or may protect from HIV infection

5. Biomedical activities for PCVs  Communities to mobilize and access services  Behavior change related to services  Training of community, health care workers  Linkages between health facilities and communities

6. Behavioral activities for PCVs Provide comprehensive sexuality education Reduce sexual partners (including MCP) Promote consistent, correct condom use Increase uptake of HIV testing and counseling Decrease alcohol use and risky sex Reduce high-risk behaviors Create demand for HIV prevention services

7. Structural activities for PCVs Reduce alcohol abuse Combat stigma and discrimination Advocate for legal/policy reform Promote harm reduction approaches Employ right-based approaches Address gender norms Reduce poverty Improve education

8. Core interventions in combination prevention (PEPFAR 2013) Prevention of mother-to-child transmission (PMTCT) of HIV Antiretroviral treatment (ART) for people living with HIV Voluntary medical male circumcision (VMMC) for HIV prevention HIV testing and counseling (HTC) Condoms Other evidence-based and appropriately-targeted prevention activities