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From the Surgeon General
November 28, 2001

Global HIV/AIDS Revisited

JAMA. 2001;286(20):2535. doi:10.1001/jama.286.20.2535

In April 1999, I wrote one of my first columns on global HIV/AIDS ("The Global HIV/AIDS Epidemic," available at http://jama.ama-assn.org/issues/v281n16/ffull/jsg91001-1.html). It is now an opportune juncture to revisit this issue.

I stated then and I reiterate now that "we know what works." While the work to develop microbicides and vaccines continues, the emphasis must be upon the basic elements of prevention—education, behavioral change, voluntary testing and counseling, prevention of mother-to-child transmission, and political commitment. We must emphasize prevention yet not ignore treatment—including palliative care, treatment of opportunistic infections, and antiretroviral treatment. Calls for a "choice" between prevention and treatment represent a false dichotomy; prevention and treatment are mutually reinforcing.

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