HIV has infected 60 million people since it began. Each day 14,000 new HIV infections add to the epidemic's staggering impact on health and, ultimately, on the social and economic stability of nations. But lives can be saved if people are willing and able to adopt safer and healthier behaviours for their sexual and reproductive health. Helping them do so is a UNFPA priority.

UNFPA supports reproductive health programmes in more than 140 countries - nearly all with interventions to prevent HIV infection. The Fund focuses on HIV prevention among young people and pregnant women, as well as condom programming. This work is carried out through reproductive health programmes in diverse situations, from community-based services to humanitarian assistance in times of crisis.

Estimated number of adults and children newly infected with HIV in 2001:

Source: UNAIDS, AIDS Epidemic Update: December 2001

Raising Awareness

AIDS is on track to wipe out 50 years of development gains in the most affected countries. Development gains are being rolled back as countries lose many of their young and most productive people to the epidemic, as poverty and inequality deepen as a result of HIV/AIDS, and as the costs of the epidemic mount. Prevention is an urgent priority:

• Every hour of every day, almost 600 people are infected. Five million men, women and children were newly infected in 2001.

• The toll is rising. About 40 million people are living with HIV/AIDS worldwide today, a number that is 50 per cent higher than the figure projected in 1991.

• Half of all new infections occur among young people aged 15 to 24, who now make up one third of those living with HIV/AIDS. In sub-Saharan Africa, young women are now up to six times more likely than young men to be infected with HIV.

• HIV/AIDS is now the leading cause of death in sub-Saharan Africa. Worldwide, it is the fourth-biggest killer. AIDS claimed 3 million lives in 2001.

HIV/AIDS is higher than ever before on the political agenda of countries around the world. In June 2001, world leaders at the United Nations General Assembly Special Session (UNGASS) on HIV/AIDS stated: "Prevention must be the mainstay of our response."

Strategy for Prevention

The UNFPA response draws on more than 30 years of experience addressing sensitive issues that cut across many different sectors and finding ways to work in diverse social, cultural and religious settings. For UNFPA, HIV prevention is based on our mandate to prevent sexually transmitted infections of all kinds and to promote reproductive rights.

UNFPA's strategic programming framework focuses on three core areas:

• Preventing HIV infection in young people;
• Condom programming;
• Preventing HIV infection in pregnant women.

To create an enabling environment for action, UNFPA addresses a number of cross-cutting issues:

• Mainstreaming gender concerns;
• Population and development concerns;
• Advocacy and partnerships;
• Capacity building.

Activities are carried out in a variety of programme settings:

• Emergency and conflict situations;
• Maternal health;
• Family planning;
• STI and other reproductive health service delivery settings;
• Informal settings to reach high-risk groups.

Behaviour Change

UNFPA supports a wide variety of interventions in behaviour-change communication and life skills education that take into consideration age, gender and cultural setting. The aim is to encourage positive and healthy lifestyles and social norms and safer sexual behaviours. Especially for young people, this entails promoting positive attitudes and skills - self-esteem, negotiation, coping, critical thinking, decision-making, communication and assertiveness.

Global Response

Reproductive health information, services and supplies enable people to avoid HIV infection and to protect themselves, their partners and their unborn children from this deadly virus. UNFPA carries out prevention efforts as a cofounder of the Joint United Nations Programme on HIV/AIDS (UNAIDS) and in cooperation with governments, non-governmental organizations and other key partners.

Prevention works and nations agree to the need for action. The challenge is to create an environment in which HIV/AIDS is addressed openly, honestly and directly - and to mobilize action to guarantee prevention, care and treatment to all who need it. In addition to incorporating HIV prevention throughout its programming, UNFPA is an outspoken advocate for increased awareness of the threat and its links to poverty and gender inequity, and for changes in policies, laws and practices to prevent further infections and protect people living with HIV/AIDS. In June 2001, world leaders at the United Nations General Assembly Special Session (UNGASS) on HIV/AIDS stated: "Prevention must be the mainstay of our response."

UNFPA has much to offer in the fight against HIV/AIDS, drawing on more than 30 years of experience addressing sensitive issues that cut across many different sectors in diverse social, cultural and religious settings. For UNFPA, HIV prevention is based on our mandate to prevent sexually transmitted infections of all kinds and to promote reproductive rights.

Examples of UNFPA in Action

• Peer education on HIV/AIDS is carried out in Botswana by faith-based organizations such as the Young Women's Christian Association and the Botswana Christian Council, with support from UNFPA. Some churches have started to manage adolescent sexual and reproductive health clinics.

• In Cambodia, a new AIDS Impact Model (AIM) is the centrepiece of advocacy efforts highlighting the socio-economic impact of HIV/AIDS and mobilizing action by decision makers. The model will be used to generate a national dialogue on policy and planning.

• To build capacity for voluntary counselling and testing in Uganda, UNFPA supported a programme to expand services that served more than 70,000 adults and adolescents in 2001. The programme featured training in counselling, testing and interpersonal communication skills; procurement of equipment and supplies; and the creation of Post-Test Clubs with monthly support meetings.

• Pregnant women in three provinces of the Dominican Republic are the focus of prevention efforts including information, counselling, screening tests and access to condoms through expanded and improved reproductive health services. Training in prevention has been provided for doctors and other health personnel.