Beyond the dichotomy: linking HIV prevention with care.

In the past decade, the global strategy against AIDS has focused primarily upon prevention. Regardless of the effectiveness of prevention efforts being made today and advances in treatments, the numbers of persons infected globally continues to grow at an alarming rate, especially in developing countries. With numbers of infections increasing, and the trend to more people learning their HIV status earlier, demands for care will mount dramatically into the next century. This paper examines the virtually unexplored role care can play in prevention and its potential to have a mitigating effect on the pandemic. Critical issues addressed include (i) the relationship between care, HIV and productivity; (ii) the role of both care and prevention in promoting acceptance of HIV/AIDS as a community problem; (iii) the role of care in decreasing the vulnerability to HIV in specific populations such as women and children; (iv) the role of care in sustaining behavior change over time for infected persons; and (v) the synergy between improved treatments and prevention. Future areas of research are proposed examining these prevention and care issues that move beyond the traditional dichotomy.