HIV Prevention Strategies and Sexual Behavior

A multifaceted array of strategies underpins contemporary efforts to curb HIV transmission by altering and supporting safer sexual behaviour. Biomedical interventions such as pre-exposure prophylaxis and antiretroviral therapy have been complemented by barrier methods, chiefly consistent condom use, while behavioural and structural approaches target knowledge, gender norms and access to services. Achieving viral suppression not only benefits the health of people living with HIV but also reduces the risk of onward transmission. Understanding patterns of sexual behaviour—including partner selection, disclosure of status and condom negotiation—is crucial to tailoring interventions that are acceptable across diverse contexts. Recent work emphasises the need for integrated programmes that link testing, treatment and prevention, address social determinants such as alcohol use and education, and deploy spatial or network-based targeting to reach high-risk populations. Such strategies carry global significance in striving for epidemic control and are informed by evidence from both large-scale surveillance and community-level studies.

Research from Nature Portfolio

A 2024 meta-analysis synthesised data on condom use among HIV-positive individuals in sub-Saharan Africa and found that fewer than half consistently employed condoms over fifteen years. The study highlighted annual fluctuations in practice and underscored regional barriers to sustained use, calling for tailored efforts to identify and overcome cultural, structural and individual obstacles.

An earlier cross-sectional survey conducted in South Africa revealed that individuals engaging in higher-risk sexual behaviour were less likely to know their HIV status and achieve viral suppression. Those with multiple partners exhibited inconsistent condom use and poorer linkage to care, indicating that risk behaviour correlates with gaps in testing and treatment uptake.

HIV Prevention Strategies and Sexual Behavior publication trend

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

Technical terms

Antiretroviral therapy (ART): Treatment regimen using multiple drugs to suppress HIV replication and restore immune function.

Pre-exposure prophylaxis (PrEP): Preventive use of antiretrovirals by HIV-negative individuals to reduce infection risk.

Viral suppression: Reduction of HIV viral load in blood to undetectable levels, lowering transmission risk.

Consistent condom use: Correct and regular use of condoms during all sexual acts to prevent HIV and other STIs.

Sero-discordant partnership: Sexual relationship in which one partner is HIV-positive and the other is HIV-negative.

References

1. Consistent condom utilization among sexually active HIV positive individuals in Sub-Saharan Africa: systematic review and meta-analysis. Scientific Reports (2024).
2. Higher risk sexual behaviour is associated with unawareness of HIV-positivity and lack of viral suppression – implications for Treatment as Prevention. Scientific Reports (2017).
3. Risky sexual behaviors and associated factors among adult patients on antiretroviral treatment at Mankweng Hospital in Limpopo Province, South Africa. Frontiers in Public Health (2023).
4. Sexual behaviour change following HIV testing services: a systematic review and meta‐analysis. Journal of the International AIDS Society (2020).
5. A Spatial Approach for Ending the Human Immunodeficiency Virus Epidemic for the United States—A DC Model. Clinical Infectious Diseases (2020).