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AJPH First Look, published online ahead of print Nov 30, 2006
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January 2007, Vol 97, No. 1 | American Journal of Public Health 13-18
© 2007 American Public Health Association
DOI: 10.2105/AJPH.2005.074591

COMMENTARY

Going Beyond "ABC" to Include "GEM": Critical Reflections on Progress in the HIV/AIDS Epidemic

Shari L. Dworkin, PhD, MS and Anke A. Ehrhardt, PhD

Shari L. Dworkin and Anke A. Ehrhardt are with the Department of Psychiatry, Columbia University, New York, NY and the HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute and Columbia University, New York.

Correspondence: Requests for reprints should be sent to Dr. Shari L. Dworkin, HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute and Columbia University, 1051 Riverside Drive Unit 15, New York, NY 10032 (e-mail: sld2011{at}columbia.edu).

A considerable number of studies have sought to identify what factors accounted for substantial reductions in HIV seroprevalence after several countries deployed "ABC" (abstinence, be faithful, condom use) strategies. After much public discourse and research on ABC success stories, the Joint United Nations Programme on HIV/AIDS 2004 epidemic report indicated that nearly 50% of infected people worldwide were women, up from 35% in 1985.

In light of the feminization of HIV/AIDS, we critically assess the limitations of ABC strategies. We provide 3 additional prevention strategies that focus on gender relations, economics, and migration (GEM) and can speak to the new face of the epidemic. Pressing beyond ABC, GEM strategies provide the basis for a stronger central platform from which national efforts against HIV/AIDS can proceed to reduce transmission risks.




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