Positive prevention aims to promote the health of people living with HIV (PLHIV) through a human rights approach. While prevention programs have historically focused on testing and preventing transmission, PLHIV have often not been involved in defining or designing these programs. This document outlines efforts to develop a definition of positive prevention led and owned by PLHIV through extensive consultations. Key elements identified include maintaining one's own health, linking prevention to treatment and care, addressing social vulnerabilities, and recognizing shared responsibility. However, questions remain around how positive prevention differs from general prevention and how PLHIV can further influence related policies and programs.

1. ‘POSITIVE PREVENTION’
by and for
people living with HIV
Philippa Lawson, Futures Group International
plawson@futuresgroup.com

2. Positive Prevention
PLHIV ask –
What does that mean?

3. Develop PLHIV Own Definition
• Why should you/I care about positive
prevention?
• What is positive prevention to you?
• What is the difference btw prevention and
positive prevention?
• How does it work in your life?
488+ in-person consultations,
+ 390 e-consultations,
+ 13 working group,
estimated 300 Living Summit

4. Define & Own by PLHIV:
Deliverables for Living Summit
• Draft PLHIV and Positive Prevention
– Background, policy & advocacy document
• Draft Call to Action
– 2 pager advocacy brief on practical steps for
global, regional, national and local level
• Draft Positive Prevention in Action
– Case Studies of PLHIV practicing PP

5. What we know:
Prevention for PLHIV To Date
• Most effective is comprehensive approach:
prevention, treatment, care and support
• PLHIV always been at forefront of
prevention programs, both + and - people
• Prevention for PLHIV practiced in
countries since the 1980s
• “Positive prevention” name began in late
1990s, early 2000s

6. What PLHIV know
People who know their + status
were not involved with
decisions to define positive prevention
and related to policy and
programmatic design,
implementation, M & E, funding and
research

7. What we know:
PLHIV Not Involved
• An overemphasis on HIV testing rather
than on the needs of people who already
know their status, and
• A focus on preventing HIV transmission
rather than on preventive health services
for people living with HIV.

8. What we know:
Prevention Works
• PPTCT (PMTCT)
• Male and female condoms
• Harm reduction
– medication assisted therapy
• ARV treatment prevents 2 million orphans
• Must link to treatment, care & support
• Preventing tuberculosis is key
• Washing Hands!

9. What we know:
“Prevention for PLHIV”
• Majority who have HIV do not know their status
• Majority of transmission is by those do not know
• Emphasis on HIV testing
• Emphasis on PPTCT & sexual transmission; not
on preventive health services for PLHIV
• Criminalization of HIV exposure & transmission
• Little attention to alcohol and drug use
• Food security, education, income impact power
and behavior of PLHIV
• Empowered PLHIV provided with support,
information & tools do protect themselves & others

10. What we do not know
• To what extent does being on antiretroviral therapy
protect against HIV transmission?
– What about non-progressors, no viral load & no ARVs?
• What are the real risks to an HIV-positive person of
being infected with another strain of the virus?
• What role will new prevention technologies play in
promoting the health of people living with HIV?

11. We agree:
Mexico PLHIV Definition
• Shared responsibility
• #1 priority - maintain & improve our own
health
– Preventing new infections or illnesses in our self
– Taking care of self, eating well, exercise, dental…
• PLHIV are best providers for PP
• Others can provide services, support, info

12. PRIORITY FOR PLHIV
SHARED RESPONSIBILITY!!

13. Positive Prevention
Key Messages
1. A human rights approach combating stigma and
discrimination is essential to the success
2. Requires addressing social vulnerabilities
– poverty, food security, gender-based violence,
xenophobia & homophobia
3. Centered on promoting health “atencion integral”
4. Will also reduce HIV transmission, yet is not
exclusively about preventing HIV
5. Linked with access to treatment, care & support
6. Everyone has a role to play

14. What we don’t agree
• The name – “Positive Prevention” (PP) – is it
offensive?
• Is Positive Prevention is only by and for PLHIV?
• Positive prevention is different than prevention
so is our definition only for people who know
their HIV positive status?
• How can people who know their positive status
get more involved and define the political
agenda for positive prevention?
• HIV transmission: Should it be included? If so
how much to focus?

15. SHUKRAN MERCI СПАСИБО
ASANTI GRACIAS THANK YOU!!
• Robert
• Tita
• Evan
• Yolanda
• Beverly
• Kate
• Rodrigo
• Anandi
• Claudio
• Jennifer
• Rita
• Beri
• Dorothy
• Elizabeth
• Terry
• Olive
• Ugo, Billy, Karen…USAID
• USAID| Health Policy Initiative
• Ken, Cynthia… Futures Group
• GNP+
• ICW
• And many others