Martin Holt (CSRH) discusses the role of social research in identifying the most effective combinations of HIV prevention methods in different populations & jurisdictions. This presentation was given at the AFAO National HIV Forum, 17 October 2014.

1. Seventh National HIV Strategy:
a research perspective
A/Prof Martin Holt, m.holt@unsw.edu.au
Never Stand Still Arts Social Sciences Centre for Social Research in Health

2. Improving monitoring & evaluation
• How do we know whether we are achieving positive
change?
– HIV incidence
– Undiagnosed infection
– HIV testing denominator (no. of people eligible for testing, not
just no. of tests performed)
– HIV treatment uptake
– Safe sex – developing better indicators of the use of risk
reduction strategies, PrEP, UVL etc.
– Stigma
– Wellbeing
• Can we identify the correct combination of efforts to
achieve and sustain change in different populations &
jurisdictions?

3. Improving access
• Access to the following technologies remains
largely under the umbrella of research studies:
– Rapid HIV testing
– HIV self-testing
– PrEP
• Arranging sustainable access is already
demanding sustained policy work and advocacy
at state & federal levels
• If kept going for too long, trials will tie up
research capacity.

4. Broadening acceptability
• Acceptability involves:
– Awareness that strategies exist
– Knowledge of how they work, what to do
– Willingness/confidence to use them
– Support for others to use them (even if you don’t)
• Individual acceptability
• Acceptability between partners
• Community support – important for sustainability
and to avoid creating stigma and divisiveness

5. HIV-negative 2011
HIV-negative 2013
HIV-positive 2011
HIV-positive 2013
Gay and bisexual men’s attitudes to HIV treatments, by HIV status
(PrEPARE Project, 2011-13, n=2100; Holt et al, in press)
Because of HIV treatments I’m less
worried about HIV infection than I used to
An HIV-positive person who is on HIV
treatments is unlikely to transmit HIV
A person with an undetectable viral load cannot pass on HIV
It is difficult to take HIV treatments every day
Taking HIV treatments is simple
and straightforward
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