title: Family wellness, not HIV prevention.
abstract: HIV exceptionalism (and disease-specific programs generally) garner both unbalanced funding and the most talented personnel, distorting local health priorities. In support of HIV exceptionalism, the successful mobilization of significant global health sector resources was not possible prior to HIV. Both sides of the debate have merits; rather than perpetuating polarization, we suggest that sustained improvements in global health require creating a prevention infrastructure to meet multiple health challenges experienced by local communities. We propose four fundamental shifts in HIV and disease prevention: (1) horizontally integrating prevention at one site locally, with priorities tailored to local health challenges and managed by local community leaders; (2) using a family wellness metaphor for services, not disease prevention; (3) implementing evidence-based prevention programs (EBPP) based on common principles, factors, and processes, rather than replication of specific programs; and (4) utilizing the expertise of private enterprise to re-design EBPP into highly attractive, engaging, and accessible experiences.
authors.affiliation: Global Center for Children and Families, University of California, 10920 Wilshire Boulevard, Suite 350, Los Angeles, CA 90024-6521, USA. Rotheram@ucla.edu
authors.forename: Mary Jane
authors.initials: MJ
authors.lastname: Rotheram-Borus
authors.forename: Dallas
authors.initials: D
authors.lastname: Swendeman
authors.forename: Diane
authors.initials: D
authors.lastname: Flannery
mesh_terms: D003153:Community Health Services / Q000458:organization & administration*; D019033:Delivery of Health Care, Integrated / Q000458:organization & administration*; D019317:Evidence-Based Medicine; D005192:Family Health; D015658:HIV Infections / Q000517:prevention & control*; D006292:Health Priorities / Q000458:organization & administration; D006293:Health Promotion / Q000458:organization & administration*; D006801:Humans; D017149:Private Sector / Q000458:organization & administration; D016730:Program Development; D012309:Risk-Taking