World AIDS Day requires us to take stock of our collective achievements in addressing HIV, while also challenging ourselves to do more and to do it better.
As PEPFAR, UNAIDS and other global development bodies continue to urge a greater focus on geographic prioritization, a focus on reaching those most marginalized remains essential. Stigma and discrimination remain enormous obstacles for many not only in blocking access to essential HIV-related services, but also in impacting the core dignity that we each hold dear. These harmful social norms and prejudices impede our ability to end new infections.
It is our belief that through the strategic use of health communication in addressing these harmful norms – while at the same time focusing the supporting factors that encourage people to seek services – great strides may be made in reaching the 90-90-90 targets. Since more than half of adults living with HIV in sub-Saharan Africa are not yet on treatment and even more who are on treatment are not virally suppressed, clear gaps remain across the cascade.
Without a solid foundation in place at treatment initiation, for example, many are lost to follow up or discontinue treatment. Given the barriers to treatment initiation and adherence, client-centered counseling focusing on the motivating factors that encourage retention is crucial. Great opportunities exist to strengthen interpersonal communication and counseling skills within health facilities, but also through community-level platforms that are trusted by community members and reach those who may otherwise delay seeking services.
Client-centered care is associated with greater client satisfaction and better outcomes. When counseling is tailored to an individual client’s needs, and there is a greater understanding of how they understand their diagnosis and what they most value as they navigate the treatment cascade, their readiness to initiate treatment and motivation to maintain ongoing adherence are strengthened.
HC3 will focus its efforts over the coming years of the project on tackling some of these and other issues as we renew our commitment to using evidence-based approaches in health communication to reach those most in need and supporting them throughout their treatment journey.
 UNAIDS 2014 estimates. Geneva: UNAIDS; 2014.