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3. Linking prevention and care
   Last updated: 29.06.02
Section 3: Linking prevention and care
Linking prevention and care enhances the impact, sustainability and credibility of the response to HIV/AIDS. It contributes to maximising the use of resources and increases the potential to reach more people including those who are most vulnerable to the impact of HIV.

HIV/AIDS prevention and care are intrinsically linked in many ways. Care and support activities improve the ability of prevention programmes to reach infected and vulnerable populations, increase the credibility of prevention programmes and by strengthening communities create a sense of ownership of the problem and its solution. More specifically, including care and support programmes in strong prevention programmes or vice-versa is a practical strategy in countries with low visibility of HIV/AIDS and a lack of services for PLHA.

The Alliance’s prevention and care programmes are based on this fundamental concept. In the first two years of the “Community Lessons, Global Learning” programme, the Alliance has been drawing on the experiences of the community based organisations it has supported to “move beyond awareness raising”. This term – which was the theme of the first year’s activities – means doing more than delivering information, education and communication (IEC). It implies action to reduce people’s vulnerability to HIV, and promote behaviour change while addressing contextual issues – such as establishing referral links to local STD services.

There are a number of practical strategies that effectively link care and support and prevention. Including PLHA in the delivery of care and support services creates opportunities for direct interpersonal links with the community and can have a dramatic effect on behaviour change. Providing voluntary testing and counselling reinforces both prevention and care and support efforts. When people know their HIV status, referral to appropriate services can support behaviour change, and in the case of those who test positive, encourage early management of opportunistic infections and facilitate planning for the future. In the case of pregnant women, voluntary testing and counselling can open the way to reducing mother to child transmission and identifying appropriate care and support for mother and child.

Linking care and prevention has been shown to increase the effectiveness of organisations implementing both kinds of programmes, whichever their primary focus may be. For example, in Burkina Faso, during the home visits carried out by La Bergerie – an NGO affiliated to a Protestant church in Ouagadougou which focuses predominantly on care and support – volunteers combine discussion of nutrition and hygiene with information about high-risk behaviour. In Cambodia, during the evaluation of a joint Ministry of Health and NGO home care initiative, community leaders said “until the home care teams started visiting people didn’t believe that there was AIDS in the village.” In the same evaluation, 87% of community leaders specifically said that the home care teams were helping to increase understanding of preventive measures. This clearly demonstrates that home care teams providing care and support were also contributing significantly to prevention efforts.

The Asociación de Mujeres del Milagro – a community group of commercial sex workers in Ecuador – became involved through a short-term HIV/AIDS awareness project by a family planning association. During this, about support to sex workers living with HIV/AIDS and discrimination by the public health system issues were raised alongside concerns about STDs and HIV/AIDS. With support from COMUNIDEC, the Alliance linking organisation in Ecuador, the Asociación took the step of combining its prevention work with developing a small health post – which is fully managed by the sex workers – to provide them with basic care and support services. They also advocated to the health sector for better care and treatment for PLHA within state institutions.

The Zambia workshop
The Zambia workshop addressed links between prevention and care and identified the following strengths of linking prevention and care:

  • Creating an enabling environment – to help acceptance of PLHA and reduce stigma.

  • Maximising resources – by integrating prevention work in community home-based care visits.

  • Utilising referrals – even if an NGO is focused on care and support work, they can at least refer someone to a prevention initiative.

  • Developing holistic programmes that cater to a range of needs.


(Reference: Report of Workshop on “Sharing Lessons in Community Care and Support for People Living with and Affected by HIV/AIDS”, Zambia, July, 1999)

Why Are Prevention & Care Linked?

“Programmes would not be complete without the combination of prevention and care. It’s not meaningful if you do prevention without care, or care without prevention. The elements are inter-related and can’t be separated. They’re both integral to an effective programme.”
Clement Mufuzi, Co-ordinator, Network of Zambian People Living with HIV/AIDS


“In terms of care, orphans and vulnerable children tend to need treatment for common diseases – such as diarrhoea – rather than being HIV-positive and needing treatment for that. However, prevention strategies are missing from this work. The reality is that these young people are growing and facing new opportunities – such as sexual activity – which mean new needs to be addressed.”
John M Munsanje, Project Manager, Children in Distress Project, Family Health Trust (FHT)

Source: Care, Involvement and Action
This is an extract from Care, Involvement and Action: Mobilising and supporting community responses to HIV/AIDS care and support in developing countries, published by the International HIV/AIDS Alliance in July 2000.

To view the whole report follow this link

To download, complete with graphics, in pdf format (which requires Adobe Acrobat software to read it) follow this link (file size: 455 Kbytes).