A quarter century of AIDS

An estimated 40 300 000 people are living with HIV infection around the globe, of whom 4 900 000 were infected during the year 2005 alone.2 The explosive trends in the global epidemic have also occurred in the United States; an estimated 925 000 to 1 025 000 HIV-seropositive persons resided within the United States in 2003.3 Unless we find ways to field effective AIDS prevention and treatment programs on a global basis, we will continue to stand witness as a dangerous epidemic spins out of control, with tragic repercussions for the rest of this new century. A series of meta-analyses of randomized, controlled trial outcome evaluations has shown that AIDS prevention model programs that directly target the topics of safe sexual practice or drug use yield significant positive effects among a variety of risk groups8-12 and among HIV positive people.13-14 Despite the overall success of the efforts that have tested conceptual models of HIV prevention, barriers remain that hinder translation of scientific knowledge into frontline prevention practice.15-16 These barriers include not only the considerable operational challenges of faithful diffusion of science-based interventions into the field but also the translation of those interventions so that they are appropriate within specific cultural contexts.