²⁴Interventions to interrupt heterosexual transmission among commercial sex workers that have been found effective include male condom distribution when coupled with peer-led education on safe sex behaviors for commercial sex workers, sexually transmitted disease (STD) treatment for commercial sex workers, and/or distribution of educational materials in hotels frequently used for commercial sex.

Other interventions that work for high-risk groups—including commercial sex workers and their clients, IV-drug users, serodiscordant couples, and sexually transmitted infection (STI) patients—are peer-led educational workplace interventions for men who are clients of commercial sex workers; voluntary counseling and testing (VCT) for STI clinic attendees, IV-drug users, and serodiscordant couples; and notifying the sexual partners of persons at elevated risk of contracting HIV.

Effective interventions for interrupting transmission among the general heterosexual population include mass distribution and promotion—or "social marketing"—of condoms, combined with comprehensive HIV/AIDS education and improved management and treatment of bacterial STIs, as well as school-based programs for youth (peer-led education and youth-friendly prevention and treatment services) and VCT for the general population, and specifically for pregnant women.

Interventions, on the other hand, that have been found to be of limited effectiveness or of possible harm in the general population include HIV education through mass media when not combined with other approaches (measures such as condom distribution and peer education must also be involved for education to be effective), abstinence programs that weren't accompanied by condom distribution (they resulted in only limited, temporary success), and the use of nonoxynol-9 microbicide (which may, in fact, increase the risk of HIV transmission). (Gail Kennedy and George Rutherford, "Cochrane Collaboration HIV/AIDS Review Group" [memorandum, n.d.].) [Return to Text]