Tonia Poteat

Panelists covered multiple aspects of sexual risk reduction: the sustainability of conditional cash transfer (CCT) in Zambia, the impact of PrEP on STI incidence among Australian MSM, the use of HIV prevention cascade models for key populations, and Vietnam’s strategy for developing a commercial condom market to ensure sustainability.

The STI reduction benefits of conditional cash transfers (CCT) in rural Tanzania were sustained one year after intervention cessation for men but not for women. While STI incidence increased among MSM using PrEP in Australia, the majority of this increase was due to repeated STIs among a small proportion (13%) of participants. Assessment of the HIV prevention cascade among FSW in Zimbabwe found only 54.7% were covered by condoms and/or PrEP. However, challenges with measurement, particularly structural factors, may limit the usefulness of the HIV prevention cascade as a tool. Implementers should consider adapting cascades to include HIV transmission as well as acquisition risk; and consider the difference between client-centered versus program-centered approaches. Vietnam was successfully transitioned from free donor condoms to a robust commercial condom market that was acceptable and affordable for key populations using careful, strategic planning and government support for quality control.

This informative session raised important issues to consider when implementing HIV and STI prevention programs. Careful consideration of sustainability, local contexts, gender dynamics, structural factors, and measurement approaches are critical to developing useful tools for sexual risk reduction.