One thing that struck me when looking across the papers for today is that while the specific groups most at risk vary nation to nation, the prevalence of HIV infection seems to be inversely associated with social status.
Men in South Africa account for only 58% of the HIV infection rates of women. This gender disparity could in part be linked to the fact that despite improvements post-apartheid, in general, all racial and ethnic groups in South Africa hold that women are less important, or less deserving of power, than men. With specific regard to HIV infection, the rise of myths in the wake of the crisis that intercourse with a virgin can cure the disease are accepted in the community even by educated people placing young women already vulnerable due to their youth and relative lack of social capital within a patriarchal system at particular risk. In accordance with the Chicago Report in the United States, it is homosexual men, intravenous drug users and among heterosexual couples, African American women who face the greatest HIV burden. What unites these three groups is a history of discrimination and disparate care within the US healthcare system that casts into question the quality of their care and reduces the likelihood they will attempt to seek care for themselves. The fact that 57% of new AIDS diagnosis in Chicago occurred in African Americans is likely related to these factors as well.
Much of the work in this space is largely based upon or are themselves predictive models. While this allows for the selection of the best practices and facilitates construction of highly effective and affordable theoretical interventions it also spares these interventions the complexities inherent to implementation. The critical step will come when theory is converted into practice. Truly effective responses to HIV must ensure the same societal barriers that led to disparate rates of infection do not preclude the most vulnerable from receiving the care they need if an effective and equitable end to the HIV/AIDS crisis is to be achieved.