HIV Prevention Strategies and Community Engagement

HIV prevention has evolved into a multifaceted discipline combining biomedical, behavioural and structural approaches. Biomedical tools now include oral pre-exposure prophylaxis (PrEP), long-acting injectable formulations, topical microbicides and preventive vaccines under development. Treatment as prevention (TasP) leverages the principle that individuals on effective antiretroviral therapy with sustained viral suppression do not transmit HIV. Behavioural interventions range from condom promotion and safer-sex counselling to digital risk-reduction platforms. Structural efforts address policy, stigma reduction, legal barriers and the social determinants of health, recognising that socioeconomic vulnerability and discrimination undermine uptake of biomedical technologies. Community engagement is integral at each stage: from co-designing clinical trials with affected populations, to peer-led adherence support, faith-based outreach and the use of mobile clinics and social media to extend reach. Effective engagement fosters trust, tailors services to cultural contexts and empowers networks of people living with or at risk of HIV to advocate for equitable access and sustained prevention outcomes across diverse settings.

Research from Nature Portfolio

Recent studies have demonstrated that long-acting injectable antiretroviral agents can maintain protective drug levels for two to three months, markedly improving adherence compared with daily oral regimens, and driving down incidence in high-risk cohorts. Parallel research has explored lipid-based nanoparticle microbicide formulations, showing promising retention of active agent in vaginal tissue and minimal mucosal irritation, paving the way for over-the-counter prevention options. Additionally, novel viral vector and mRNA vaccine candidates are eliciting robust mucosal and systemic immune responses in preclinical and early-phase trials, offering hope for a vaccine that both prevents infection and reduces community viral load when integrated with existing interventions.

HIV Prevention Strategies and Community Engagement publication trend

The graph below shows the total number of articles in hiv prevention strategies and community engagement across all publications each year (not limited to Nature Index journals).

Technical terms

Pre-exposure prophylaxis (PrEP): A biomedical intervention in which HIV-negative individuals take antiretroviral drugs to prevent infection.

Treatment as prevention (TasP): The use of antiretroviral therapy by people living with HIV to achieve undetectable viral load and prevent onward transmission.

Microbicide: A topical formulation applied to mucosal surfaces to block HIV entry and replication at sites of exposure.

Undetectable viral load: The state in which HIV RNA in blood is below the threshold of standard assays, indicating effective therapy and negligible transmission risk.

Community engagement: The process of involving affected populations in the design, implementation and evaluation of HIV prevention programmes to ensure relevance, acceptability and equity.

References

1. Insights into barriers and facilitators in PrEP uptake and use among migrant men and transwomen who have sex with men in Belgium. BMC Public Health (2023).
2. Trends in HIV pre-exposure prophylaxis use in eight Canadian provinces, 2014–2018. Relevé des maladies transmissibles au Canada (2021).
3. “What other choices might I have made?”: Sexual Minority Men, the PrEP Cascade and the Shifting Subjective Dimensions of HIV Risk. Qualitative Health Research (2022).