Social Policy: Going Upstream

Anna Vassall, Michelle Remme, Charlotte Watts Rethink HIV, 2011; The Copenhagen Consensus Center and The Rush Foundation Download publication

An analysis of the costs and benefits of interventions that seek to address some of underlying social drivers of HIV vulnerability. The paper was written by STRIVE researchers at LSHTM including the consortium’s Research Director Charlotte Watts. It focuses on four social drivers of HIV vulnerability:

  • Widespread problematic alcohol use
  • Transactional sex between young girls and older men
  • Established social norms about gender roles and behaviours
  • Stigma and discrimination towards people infected with or affected by HIV

The paper estimates the costs and benefits of the following corresponding interventions:

  • Increasing alcohol taxes
  • Keeping girls in secondary school
  • Adding participatory gender and HIV training to existing microfinance and livelihood programmes with women and/or men
  • Investing in community mobilisation and stigma reduction involving those who are most vulnerable to or affected by HIV

Through a detailed review of these interventions, the paper argues that there are important social policy interventions that could have a significant long-term impact on the HIV epidemic at a comparatively low cost, and that are likely to have both HIV and development related benefits.

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