Since the US Agency for International Development （USAID) began its first HIV/AIDS prevent

Since the US Agency for International Development (USAID) began its first HIV/AIDS prevention efforts eight years ago, the epidemic has changed dramatically. HIV has spread to every region of the world. Millions of people infected with HIV during the first decade of the epidemic are developing opportunistic infections and other AIDS-related illnesses, and many are dying. Women and children are among those most vulnerable to HIV infection. As HIV prevalence and AIDS mortality soar, millions of children will lose their parents.

HIV/AIDS is having a devastating impact on the health and well-being of families, communities and nations worldwide. The epidemic's effects on the structure of societies and the productivity of their members undermine efforts to promote sustainable development around the globe.

USAID's approach to slowing the spread of HIV/AIDS relies on strategies tested and refined over the past eight years. At the same time, the Agency is moving forward to address new challenges posed by the evolving epidemic.

One of the important lessons learned during the past decade is that an effective response to HIV/ AIDS requires the full participation of people and communities affected by the virus. Although people living with HIV/AIDS are among the most successful advocates and communicators for prevention, too often their voices are not heard or heeded. Greater involvement of people living with HIV/AIDS is essential to creat the supportive political, legal and social environments needed to control the epidemic.

In December 1994 at the Paris AIDS Summit, representatives of 42 governments adopted resolution pledging greater support for networks of people living with HIV/AIDS. Before and during the summit, members of these networks worked with government and multilateral organizations, including USAID, to develop a plan for translating the words of the resolution into concrete action. The Agency is committed to ensuring that people living with HIV/AIDS are accepted in full partnership with governments, international organizations and the private sector in developing, implementing and evaluating HIV/AIDS policies and programs.

People living with HIV/AIDS and community-based organizations have been at the forefront of efforts to draw attention to the connection between compassionate AIDS care and effective HIV prevention. In the absence of a vaccine or cure, USAID continues to emphasize HIV/AIDS prevention. But as the number of people suffering from AIDS-related illness begins to increase dramatically, the Agency is also exploring ways to reduce the social impact of AIDS and enhance prevention efforts by integrating prevention and care.

The Agency will also continue to pioneer regional approaches to an epidemic that does not recognize national boundaries. Crossborder interventions throughout the world will target mobile populations, including migrant workers, tourists, traders, transport workers and people displaced by war, and social disruption.

Results from USAID-supported research on preventing HIV/AIDS in women, from microbiocide development to behavioral research on communication between men and women, will play a key role in slowing the rapid spread of the epidemic in the future. The Agency will continue to support research designed to strengthen programs for women and will move quickly to incorporate promising prevention methods into field activities. USAID will also work to reduce women's vulnerability to HIV prevention by promoting multisectoral efforts to improve their economic and social status.

Recognizing the growing threat HIV/AIDS poses to child survival, the Agency will support efforts to identify and test methods of preventing transmission from mother to child, such as Vitamin A supplements and other promising interventions. In addition, USAID will expand efforts to reduce HIV/ AIDS am

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