Biomedical & structural prevention

Publication Subtitle

STRIVE in the era of ‘cascades’

Publication year


Publication Author

STRIVE Consortium | Sinéad Delany-Moretlwe, James Hargreaves, Anne Stangl, Mitzy Gafos

Despite advances, an unmet need remains for HIV prevention, both through primary prevention for HIV negative individuals and secondary prevention through treatment for HIV positive individuals. This need is urgent in key populations such as sex workers, men who have sex with men, prisoners, people who use drugs, transgender people and adolescent girls and young women in sub-Saharan Africa.

The advances in antiretroviral (ARV)-based primary and secondary prevention offer real promise for reducing HIV incidence at a population-level, if sufficient coverage is achieved. However, the impact at population level of treatment as prevention (TaSP) has been constrained by the realities of people’s lives. In the past, interventions to overcome barriers to the uptake of prevention methods focused on behavior change. Increasingly, though, the field has come to acknowledge that individual choices are shaped at the structural level. Thus, prevention strategies must address the structural factors that inhibit or enhance the uptake of direct mechanisms of HIV prevention to achieve a population-level impact.

The STRIVE consortium set out to address two key sets of questions:

1. How do structural factors influence the success of biomedical prevention tools?
2. Can programs address structural factors in order to optimize the impact of biomedical HIV prevention?

To learn more, download the technical brief below.