Policy Recommendations

1 Restore A, B, and C to their public health roots.
“A,” “B,” and “C,” broadly defined to include delaying first sex and partner reduction, represent the primary behaviors that must be adopted to reduce sexual transmission of HIV. Based on their public health roots, these are the behavioral outcomes that should be promoted equally through a range of prevention approaches.

2 Promote the whole alphabet of HIV prevention approaches.
In order to achieve the behaviors, broadly defined, of A, B, and C, HIV programs must promote a full range of prevention interventions, including, among other interventions, access to safe circumcision for men, legal protection for vulnerable populations, promotion of human rights and gender equity, access to livelihoods, and availability of comprehensive evidence-based information and services. The evidence base for these and other prevention programs is vast (e.g. Gay et al., 2005).

3 Give people the complete and comprehensive information they need to decide for themselves which prevention behavior is most appropriate in the context of their lives.
Narrow messages that focus on abstaining until marriage, being faithful in marriage and only resorting to using condoms for high risk sex have had unfortunate results for youth who are not given comprehensive information and preparation for when they do become sexually active, for “faithful” wives who become infected by their husbands (and vice versa) and for people who cannot access condoms due to shortages and policy and program barriers. Presenting each prevention element non-judgementally and as a choice people make for themselves, will be far more acceptable to most people than narrow messages of ABC that do not fit the context of most people’s lives.

Image 9: Street sign in Tanzania-"Usione Soo" Don't be shy! (Talk to your partner about waiting, being faithful, or using a condom). Photograph by Karen Hardee.	Image 10: At Kasisi Girls High School in Lusaka, Zambia, a young woman tries to cross a metaphorical river and avoid HIV/AIDS. This activity was part of a Health Communication Partnership (HCP)-sponsored HIV prevention program promoting abstinence, being faithful to one partner, or consistent condom use. Courtsy of JHU/CCP.