Structural drivers and interventions: State of the evidence and barriers to action

Samson StructuralDeterminants20140109.pdf

Michael Samson summarises what we know about the structural factors shaping HIV risk and how to tackle them.

A high-level meeting in Washington, DC on 9 January 2014 addressed the social drivers of AIDS and extreme poverty. In this presentation to the gathering, the research director of EPRI (the Economic Policy Research Institute) synthesises the existing evidence base in order to:

  • clarify definitions of key terms for the field
  • review models (several by STRIVE researchers) to tease out the causal pathways between structural factors and HIV vulnerability
  • spotlight findings on structural interventions (whether integrated or behaviourist)
  • identify knowledge gaps
  • propose and explain a development planning matrix

Samson concludes with three key messages:

  1. There is an established and growing evidence base on the impacts of structural interventions on key HIV outcomes, including prevention and treatment access and adherence (as well as care and support and mitigation)
  2. One key priority is the implementation of more comprehensive and integrated interventions which can optimize both the AIDS response and achieve greater progress in tackling poverty and promoting pro-poor and inclusive growth and development
  3. One critical barrier to this action is the lack of tools (such as financing mechanisms) to support cross-sectoral planning and resource allocationon

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