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New York, New York, OSAGI, .  p.Her name is Joyce Puta, a 48-year-old Zambian army colonel on secondment to the United Nations. An unabashed fighter, her enemy for the last ten years has been HIV/AIDS. Her latest battleground is Liberia, and by all accounts she has been waging a successful campaign. Working with the United Nations Mission in Liberia (UNMIL), Colonel Puta points out that any environment requiring peacekeepers is also a risky one for the spread of HIV/AIDS. In post-conflict situations, social structures crumble and economies are unstable. In order to survive, desperate young women may turn to commercial sex work, often around military bases. So how did a career Zambian army officer find herself on the frontlines in the fight against HIV/AIDS? Joyce Puta joined the army at eighteen. Six years later she became a registered nurse and midwife, and then nursing services manager for Zambia's main military hospital. (excerpt)
Health Policy and Development. 2004 Aug; 2(2):131-135.International agencies are beginning a rapid scaling up of antiretroviral distribution programs in Africa. Some are particularly looking for "faith-based organizations" (FBOs) as partners. The new initiatives may offer both unprecedented opportunities and some dangers for FBOs who wish to join in. The opportunities include increasing our capacity to provide not only HIV/AIDS care but other aspects of health care, and a potential for increased communication and cooperation between Christian organizations. The dangers include the likely widespread appearance of antiretroviral resistance; long term sustainability; negative impact on other aspects of HIV care and prevention; indirect costs to FBOs; corruption; encouragement of a culture of money and power, drawing FBOs away from their perceived missions; overextension; and harmful competition among FBOs. Organizations should be aware of the opportunities and dangers, and review their own calling and mission, before embarking on large-scale, externally-funded programs of ARV distribution. (author's)
Challenging, changing, and mobilizing: a guide to PLHIV involvement in country coordinating mechanisms.
Washington, D.C., Futures Group, POLICY Project, 2004 Dec. 99 p.The aim of the handbook is to increase and improve the meaningful participation of PLHIV on CCMs across the world. This development will undoubtedly enhance the ability of the Global Fund to be an effective force in serving the communities most in need and will also contribute to facilitating PLHIV access to Global Fund resources. There are already many useful resources available nationally (though not in every country) and internationally to assist PLHIV in developing various types of skills and knowledge; however, none is specific to PLHIV who are involved in Global Fund CCM processes. We realized during the consultations that we could fill hundreds of pages with useful and relevant information, so instead of duplicating material that already exists, we will refer to it where appropriate. To the greatest extent possible these resources have been included on the CD that accompanies this handbook. (excerpt)
Choices. 2004; 4-5.This approach is underpinned by promoting leadership in government, in civil society, in the private sector and in communities. We promote leadership of people living with HIV/AIDS and women's leadership to ensure that they participate in planning and implementing HIV/AIDS responses. We also work with a broad range of partners, including from the media and in the arts, to generate society-wide responses that are gender-sensitive and respect the rights of people living with HIV/AIDS. We also work to strengthen community capacity for action and social change by helping communities to address the underlying causes of the epidemic. (excerpt)
Choices. 2004; 6.HIV/AIDS has reached the proportion of a pandemic because human rights continue to be violated on a massive scale. During my term as UN High Commissioner for Human Rights, and in the years since, I have seen first-hand how these rights violations fuel the spread of HIV/AIDS. I have met with women in rural areas across Africa who feared losing their homes and being rejected by their families due to their actual or suspected HIV status. I will never forget the elderly man I met in Delhi who was refused hospital treatment for a broken hip because he was HIV positive, or the discrimination against the gay, lesbian and transsexual community recounted to me by a group in Argentina, every one of whom had a personal story of rejection and hardship. (excerpt)
Choices. 2004; 7.I left the 1998 International AIDS Conference in Geneva frustrated and angry. The slogan of the conference--'Bridging the Gap'--was right on target, but none of the major players in the conference (the international agencies, governments, the big pharmaceutical companies) offered a vision, let alone a strategy, for making life-saving treatments available to the millions of HIV-positive people in poor and developing countries. As has been true since the beginning of the AIDS epidemic, it was left to HIV-positive people themselves and to advocacy groups to formulate demands, mobilize the political support to challenge the status quo and lead in the development of new policies. Dramatic changes have occurred between 1998's 'Bridging the Gap' and 2004's 'Access for All' conferences. In the intervening six years, an alliance of NGOs from around the world with a bloc of progressive poor and developing countries has won significant victories: It is no longer morally acceptable to do nothing about the death and suffering of millions; The broader global AIDS community has accepted that any effective approach to stopping the epidemic must include treatment as well as prevention and mitigation. (excerpt)
New York, New York, UNDP, 2004 Jul.  p.The HIV/AIDS epidemic is one of the world's most serious development crises. An estimated 3 million people died of AIDS in 2003 and 5 million acquired HIV -- bringing the number of people living with the virus around the world to 38 million. Without decisive action, not only will we fail to achieve the goal of reversing the spread of HIV/AIDS, but worse: the number of people infected is likely to double in less than a decade. International funding to respond to the epidemic has increased, but it will take comprehensive and sustained intervention in both high and low prevalence countries to turn the tide. (excerpt)
Nairobi, Kenya, Ministry of Health, 2004 Jun.  p. (IUCD Method Briefs Update)The World Health Organization (WHO) recently revised the guidelines for IUCD use as part of an update of its Medical Eligibility Criteria for Contraceptive Use (MEC). These revisions will improve quality of care and reduce medical barriers for women who are considering an IUCD as a contraceptive method. Based on the latest clinical and epidemiological research, the revisions are particularly significant for women at risk of sexually transmitted infections (STIs), including HIV, and women living with HIV or AIDS. Research has shown that while some conditions restrict IUCD initiation, they do not necessarily affect the safety of continued use. Under the new guidelines, for example, a client who has gonorrhea or chlamydial infection is considered a Category 4 for IUCD initiation and should be advised to choose another method. However, if an IUCD user develops an STI, she can be treated with antibiotics without the IUCD being removed (Category 2). In addition, the client should be counseled about partner notification and treatment, and condom use. (excerpt)
[Kyiv], Ukraine, UNDP, . 11 p.HIV/AIDS presents the greatest challenge to human development the world has ever seen. With nearly 42 million people living with HIV/ AIDS, 20 million already dead and 15,000 new infections daily, its devastating scale and impact constitute a global emergency that is undermining social and economic development throughout the world and affecting individuals, families, communities and nations. HIV/AIDS reverses gains in human development and denies people the basic opportunities for living long, healthy, creative and productive lives. It impoverishes people and places burdens on households and communities to care for the sick and dying, while claiming the lives of people in their most productive years. HIV/AIDS also results in social exclusion and violations of human dignity and rights affecting people's psychological well-being. While the long-term consequences may not yet be visible here, Ukraine is glimpsing the enormity of the problem in its newly independent country. The number of reported cases of HIV infection in the country has increased 20 times in the past five years yielding estimates of 300,000 to 400,000 people already infected, which is approximately 1% of the adult population. The Declaration of Commitment of the UN General Assembly Special Session on HIV/AIDS notes "the potential exists for a rapid escalation of the epidemic". The dynamics of the spread of the epidemic can be indicative of the potential magnitude of future human development impacts, deepening over time and affecting future generations. (excerpt)
New York, New York, UNDP, 2004 Jun. 34 p.Something remarkable is happening in many parts of the world. Faced with a common enemy, people from different countries are discovering a shared goal. These are ordinary men and women who until recently had thought of HIV/AIDS as something that happened to other people. Responding to the epidemic has today become a passionate cause for each one. These individuals and groups are linked by one common factor: They have all been part of UNDP's Leadership for Results programme-- a unique and innovative process that helps to create an enabling environment to halt and reverse the spread of HIV/AIDS, by fostering hope, generating transformation and producing breakthrough results. (excerpt)
Paris, France, UNESCO, 2004 Jul. 13 p. (Literacy, Gender and HIV / AIDS Series)This booklet is one of an ever-growing series of easy-to-read materials produced at a succession of workshops supported by UNESCO and UNFPA. The workshops are based on the appreciation that gender-sensitive literacy materials are powerful tools for communicating messages on HIV/AIDS to poor rural people, particularly illiterate women and out-of-school girls. Based on the belief that HIV/AIDS is simultaneously a health and a social cultural and economic issue, the workshops train a wide range of stakeholders in HIV/AIDS prevention including literacy, health and other development workers, HIV/AIDS specialists, law enforcement officers, material developers and medial professionals. Before a workshop begins, the participants select their target communities and carry out needs assessment of their potential readers. At the workshops, participants go through exercises helping them to fine-tune their sensitivity to gender issues and how these affect people's risks of HIV/AIDS. The analysis of these assessments at the workshops serves as the basis for identifying the priority issues to be addressed in the booklets. They are also exposed to principles of writing for people with limited reading skills. Each writer then works on his or her booklet with support from the group. (excerpt)
Shock therapy in Brazil. By combining prevention campaigns and free access to drug treatment, Brazil has successfully curbed the AIDS epidemic. [Tratamiento de shock en Brasil. La combinación de campañas de prevención con el libre acceso al tratamiento con fármacos ha permitido a Brasil frenar exitosamente la epidemia de SIDA]
New Courier. 2004 Oct; 46-47.Explosive. That was the word to describe the AIDS epidemic in Brazil. In 1992, the World Bank predicted that the number of cases would exceed one million in the year 2000. The demographic growth of Brazil, a country of nearly 170 million people, heightened fears of an epidemic comparable to that sweeping Africa. But while Brazil is one of the countries in Latin America that has been hardest hit by the disease, with more than 600,000 people living with HIV, the numbers are far below the catastrophic forecasts made 10 years ago. The country has even become a point of reference for numerous developing countries in the throes of the epidemic. The daring policy adopted by the authorities in Brasilia - based on active prevention campaigns and, since 1996, the free distribution of anti-retroviral drugs to those who are sick - has turned out to be particularly effective. Currently, 140,000 Brazilians, or nearly all of those who are aware that they have the disease, are receiving free medication. Result: the AIDS related death rate has been cut in half since 1997. And contrary to what some people feared, the widespread access to treatment has not had an adverse effect on prevention. The number of new HIV infections stood at 22,000 in 2003, down from 25,000 in the 1990s. In addition, the incidence of high-risk behavior has dropped. For example, the percentage of soldiers who use a condom when having sex with a paid partner increased from 69 percent in 1999 to 77 percent in 2002. (excerpt)
Odessa workshop helps build capacity among Ukrainian clinicians who care for people living with HIV / AIDS.
Connections. 2004 Jan;  p..A recent Anti-retroviral Therapy Training Workshop held in Odessa, Ukraine, marked the start of an ongoing collaboration between AIHA and the Los Angeles-based AIDS Healthcare Foundation (AHF). It was the first training hosted under the aegis of the newly established World Health Organization Regional HIV/AIDS Care and Treatment Knowledge Hub for which AIHA is the primary implementing partner. This Knowledge Hub was created in response to the burgeoning HIV/AIDS pandemic in Eastern Europe and Central Asia to serve as a crucial capacity-building mechanism for reaching WHO's "3 by 5" targets for the region. (excerpt)
Ethical and programmatic challenges in antiretroviral scaling-up in Malawi: challenges in meeting the World Health Organization's "Treating 3 Million by 2005" Initiative goals.
Croatian Medical Journal. 2004; 45(4):415-421.The Fifty-seventh World Health Assembly's (WHA's) resolution on the "scaling up of treatment and care within a coordinated and comprehensive response to HIV/AIDS" is welcomed globally, and even more so in Sub-Saharan Africa, where the majority of the people currently in need of antiretroviral therapy do not have access to it. The WHA identified, among others, the following areas which should be pursued by member states and the World Health Organization (WHO): trained human resources, equity in access to treatment, development of health systems, and the integration of nutrition into the comprehensive response to HIV/AIDS. The WHO Director-General was requested to "provide a progress report on the implementation of this resolution to the Fifty-eighth World Health Assembly." Much of what happens between now and that time depends on the actions of the WHO and the member states and also on the contribution of the international community to the fight against HIV/AIDS. Much of what is to be done will be based on what is available now in terms of practice, human resources, and programs. This paper explores the WHA's resolution, especially regarding the scaling up of antiretroviral therapy, taking Malawi as the case study, to identify the challenges that a Southern African country may be facing which will eventually influence whether the initiative to "Treat 3 Million by 2005" ("3 by 5") will be achieved or not. The challenges southern countries may be facing are presented in this paper not in order to undermine the initiative but to create an awareness of these factors and initiate the appropriate action which would surmount the challenges and achieve the goals set. (author's)
Malaria and HIV / AIDS interactions and implications: conclusions of a technical consultation convened by WHO, 23-25 June, 2004.
Geneva, Switzerland, WHO, 2004.  p. (WHO/HIV/2004.08)Malaria and HIV are among the two most important global health problems of our time. Together, they cause more than four million deaths per year. Malaria accounts for more than a million deaths each year, of which about 90% occur in tropical Africa, where malaria is the leading cause of mortality in children below five years. Aside from young children, pregnant women are among the most affected by the disease. Constituting 10% of the overall disease burden, malaria places a substantial strain on health services and costs Africa about USD 12 billion in lost production each year. Sub-Saharan Africa is also home to more than 29 million people living with HIV/AIDS. In 2003 in Africa, AIDS claimed the lives of an estimated 2.4 million people and over 600 000 children were newly infected with the virus. HIV/AIDS increasingly accounts for a large proportion of mortality among children under five years in heavily affected countries. By taking its greatest toll on its young and most productive generation, HIV/AIDS hinders sustainable development in Africa. (excerpt)
Geneva, Switzerland, UNAIDS, 2004 Jul 6.  p.The global community is at a crossroads in expanding access to HIV treatment and care. Never before have the opportunities been so great: unprecedented political will in countries; unprecedented financial resources to fund treatment, care and support; and unprecedented affordability of medicines and diagnostics. Despite these extraordinarily positive conditions, access to antiretroviral treatment and other HIV-related disease care remains abysmally low. As part of addressing this emergency, UNAIDS, WHO and their partners are fully committed to getting 3 million people on antiretrovirals by the end of 2005. (excerpt)
Women, gender and HIV / AIDS. Women bear the heaviest HIV / AIDS burden, but they can’t prevent its spread by themselves.
Countdown 2015: Sexual and Reproductive Health and Rights for All. 2004; (Spec No):65-68.Women, especially young women, are increasingly the face of the HIV/AIDS epidemic. About half of all adults infected with HIV worldwide are women, although this proportion varies by region. In sub-Saharan Africa, 75 percent of those infected are young women and girls, and the proportion of pregnant young women in capital cities who are HIV positive—an indicator of how the epidemic is spreading— remains high in five of the most populous countries in sub-Saharan Africa. Recent data from South Africa, one of the countries hardest hit by HIV/AIDS, showed that 10.2 percent of all 15- to 24-year-olds were infected in 2003, and three of every four HIV-infected young people were female. In the United States, AIDS is now the leading cause of death among African-American women age 25-34. Even in Thailand and Cambodia, relative HIV-prevention success stories, the epidemic increasingly affects women: The rate of new infection is now higher among women than men, and many of those women are the wives of HIV-positive men. (excerpt)
Can this marriage work? Linking the response to AIDS with sexual and reproductive health and rights.
Countdown 2015: Sexual and Reproductive Health and Rights for All. 2004; (Spec No):58-63.For people involved in family planning, ICPD was a landmark event. Yet it is striking how few experts, activists and stakeholders involved in other SRHR issues, particularly HIV/AIDS, were centrally involved in Cairo. Cairo had no visible involvement of people living with HIV, and no HIV/AIDS-dedicated non-governmental organisation was amongst the many formal observing agencies. Even five years later, at the ICPD+5 meeting in New York where progress was reviewed and further targets established, only one HIV/AIDS NGO was formally present. In the years immediately following Cairo, many AIDS activists felt excluded and ignored by the SRHR community. This perception was worsened by a sense that the SRHR community was trying to “take over” AIDS, while simultaneously not taking AIDS seriously. One prominent SRHR expert repeatedly stated that “there should be no such thing as an HIV/AIDS programme”; he insisted these should be replaced with holistic sexual health strategies. The World Health Organization’s Global Programme on AIDS was abolished and replaced with what was initially a much smaller and more modestly-funded inter-agency body, UNAIDS. And by 1997 the majority of OECD donors had abolished their stand-alone global HIV/AIDS departments or budget lines and “integrated” these efforts within new or restructured SRHR funding. (excerpt)
Menlo Park, California, Henry J. Kaiser Family Foundation, 2004 Jul.  p. (HIV / AIDS Policy Fact Sheet)Young people continue to bear the brunt of the global HIV/AIDS epidemic, with youth under age 25 accounting for more than half of all new HIV infections each year. Those between the ages of 15-24 are particularly hard hit, especially girls and young women who comprise the majority of young people living with the disease. Young people face particular vulnerabilities that put them uniquely at risk for HIV, but they are also critical to the response to the epidemic; where HIV transmission has been reduced, the greatest reductions are often seen among young people. (excerpt)
Manila, Philippines, WHO, Regional Office for the Western Pacific, 2004. 44 p.This framework, which draws on the Global strategic framework to reduce the burden of TB/HIV and on the Guidelines for phased implementation of collaborative TB and HIV activities, was developed based on the following two premises. First, the National TB Programme (NTP) needs to address the impact of HIV, i.e. higher caseload of TB and increasing drug-resistant TB, and to mobilize resources related to TB/HIV activities. Second, the National AIDS Programme (NAP) needs to prolong the life and reduce the suffering of PHA through better management of TB, and to mobilize resources for TB/HIV. The Regional framework is built on the strengths of the individual National TB and AIDS Programmes, and identifies areas in which both programmes complement each other in addressing TB/HIV. This approach is considered useful, not only for countries with a relatively high prevalence of HIV, such as Cambodia, but also for most of countries in the Region that are faced with a relatively low prevalence of HIV. The scope of the Regional framework comprises interventions against tuberculosis (intensified case- finding and cure and tuberculosis preventive treatment) and interventions against HIV (and therefore indirectly against tuberculosis), e.g. comprehensive prevention, care and support, including condoms, sexually transmitted infection (STI) treatment, safe injecting drug use (IDU) and antiretroviral (ARV) treatment. Key components of the Regional framework are: surveillance; diagnosis and referral, including voluntary counselling and testing (VCT) for HIV; interventions; and, areas of collaboration. The framework outlines the roles of the individual TB and HIV/AIDS programmes (i.e. “who does what”) and provides examples of how to operationalize the different components. (excerpt)
Manila, Philippines, WHO, Regional Office for the Western Pacific, 2004.  p.The 2001 report on HIV/AIDS in Asia and the Pacific region published by the WHO Regional Offices for South-East Asia and the Western Pacific presented an overview of the HIV/AIDS pandemic, followed by a description of the general patterns and prevalence of HIV risk behaviours and HIV prevalence trends in the region, as well as in individual countries. This vast geographic region combines the WHO South-East Asia and Western Pacific Regions and contains 60% of the total world population. Thus, even low HIV infection rates in this region will contribute millions of additional people living with HIV/AIDS (PLWHA) and deaths to the already staggering global toll of AIDS. This report provides an update on HIV/AIDS in the region and focuses on the continuing HIV prevalence trends noted in the previous report. It also noted some changes that may be occurring with regard to the public health surveillance and epidemiology of HIV/ AIDS. In addition, the epidemiological patterns of HIV, especially current HIV transmission dynamics, are described for each country. HIV is primarily a sexually transmitted infection (STI) and, as with all STI, the major driving force of the pandemic is heterosexual transmission. Although high rates of HIV infection (50% and higher) have been found and may still occur among injecting drug users (IDU) and men who have sex with men (MSM), more than 90% of the global total of estimated adult infections are due to heterosexual transmission. HIV/AIDS is present at varying prevalence levels in MSM in several regions of the world. Explosive spread of HIV still occurs among IDU populations worldwide and sexual transmission occurs throughout the world in both males and females, especially in those who have unprotected sex with multiple and concurrent partners, such as female sex workers (FSW). Extensive or epidemic heterosexual spread of HIV, affecting 1% or more of the sexually active population, has occurred in sub-Saharan countries, a few countries in the Caribbean and Central America, and a few countries in South and South-east Asia. Considering the presence of risk factors for HIV infection, such as high-risk behaviours and other sexually transmitted infections, and the vulnerability to HIV infection in the region, the major public health question is what actions need to be taken to maintain this low HIV prevalence. However, a response cannot be properly formulated without understanding the HIV epidemic status and trends in the region. (excerpt)
[Unpublished] 2004. Presented on the occasion of the 23rd CCO Joint Meeting, “HIV / AIDS Prevention among Young People: Focusing on Education”. 3 p. (DG/2004/025)First of all, I should like to recall that in the Declaration of Commitment issued by the United Nations General Assembly Special Session on HIV/AIDS (UNGASS) of July 2001, many time-bound targets were made, notably to reduce HIV prevalence rates among young men and women aged 15 to 24 in the most affected countries by 25 per cent by 2005. In the world at large, there are about 14,000 new infections each day. About 6,000 of them are in the age-group 15-24 years – the young, especially girls and young women, are at risk. A large fraction of those infected are on this continent and in this region. Consequently, we have to recognize that we are falling behind, especially in regard to the 2005 target. Africa, in particular Southern Africa, is the region most affected by the HIV/AIDS epidemic. Thus, it is very important that we are meeting in Livingstone, Zambia. The six countries represented here, all drawn from southern Africa, are among the hardest hit. In addition, you are the leaders of these countries from the sectors most directly involved – health, education and finance. It is not enough for HIV/AIDS to be discussed solely in terms of health and treatment; prevention must also be addressed, in which case education is a crucial dimension. Furthermore, it is not enough simply to call for additional finance; the power and influence of the finance ministry must also engaged in the fight against HIV/AIDS. (excerpt)
[Unpublished] 2004. Presented at the opening of the conference “Africa's Cultural Responses to HIV/AIDS: Women and their Struggles”, held on the occasion of the celebration of International Women's Day. 3 p. (DG/2004/26)It gives me great pleasure to welcome you today to UNESCO on the occasion of International Women’s Day. The date of 8 March has gained recognition throughout the world as a day of mobilization and reflection, and a crucial date in the campaign for women’s rights and equality for all people. This year, the United Nations has decided to dedicate this day to the theme “Women, girls, HIV and AIDS” to reflect the theme selected by UNAIDS for the 2004-2005 world campaign against HIV/AIDS. This theme is, sadly, all too appropriate. I have just returned from a tour of southern Africa where I visited Lesotho, Swaziland, Botswana and Zambia. In all those countries, the fight against HIV/AIDS was at the heart of the debate. Indeed, southern Africa is the most severely affected subregion in sub-Saharan Africa and I was able to see for myself the terrible impact of this pandemic on the people and in particular on women and girls. Signs of its devastating consequences for the subregion are everywhere, in particular in the education system and in the course of daily life, where even the most basic services are no longer guaranteed. In Livingstone, Zambia, two meetings on HIV/AIDS were held successively during my visit. The first brought together ministers of health, education and finance of the six countries of the subregion and UNAIDS agency heads. As you are aware, UNAIDS is a joint programme run by the nine United Nations agencies involved in the fight against AIDS, including UNESCO, UNICEF, UNFPA and the World Bank. (excerpt)
Paris, France, UNESCO, International Institute for Educational Planning, 2004. 40 p. (IIEPApr. 2004/UHIVSD/R4)The HIV/AIDS epidemic is unprecedented in human history. It has been with us for 20 years — and the worst is yet to come: many millions more will be infected, many millions more will die, many millions more will be orphaned. Not only individuals are at risk — the social fabric of whole societies is threatened. The disease is likely to be a scourge throughout our lifetime. Its spread has not been curbed — on the contrary, the epidemic is expanding to new regions and spreading in some areas even more rapidly than it did in the earlier years. Unlike other epidemics, it primarily affects young adults, particularly women. It thrives on and amplifies poverty and exclusion. It strikes hardest where lack of education, illness, malnutrition, violence, armed conflicts and discrimination are already well entrenched. Yet, although it strikes the poor and disadvantaged, it also heavily affects the skilled, the trained and the educated — i.e. the groups most vital for development. Children are at risk on an unparalleled scale. Millions are already infected — in some countries more than a third of 15-year-olds will die of AIDS-related illnesses in coming years. Millions more are becoming orphans of one or both parents — more than 30 million in less than 10 years. Many youth will grow up deprived, desocialized and disconnected. Children are losing teachers at school and parents who can support them at home. In some areas classes and even whole schools are closing, resulting in a poorer education, while at the same time the economically developed world moves into the knowledge society. (excerpt)
Geneva, Switzerland, WHO, Department of HIV / AIDS, .  p.Adherence, “the extent to which a person’s behavior – taking medication, following a diet, and/or executing lifestyle changes, corresponds with agreed recommendations from a health care provider”, is a crucial element for the implementation of the HIV treatment scale-up initiative. Properly taken, HAART (highly active anti-retroviral therapy) has been shown to reduce viral loads, but the requirements for adherence are high – most studies suggest that it has to be higher than 90% to avoid the risk of resistance. (excerpt)