Half of new HIV infections by 2015 could be prevented if UNAIDS targets for HIV expenditure are met and evidence-based prevention programs are implemented, according to a new report.

The Global HIV Prevention Working Group’s report, Bringing HIV Prevention to Scale: An Urgent Global Priority, shows that prevention measures are not keeping up with new infections: for every person starting anti-HIV treatment in 2006, six were newly infected.

It is estimated there will be 60 million new HIV infections by 2015, but the report suggests that 30 million of these could be avoided if scientifically proven HIV prevention methods were implemented.

Proven prevention measures detailed in the report include increased testing, prevention efforts aimed at high-risk groups, treatment to prevent mother-to-child (vertical) transmission and male circumcision. However, the working group noted that few who could benefit from HIV prevention initiatives have access. In low and middle-income countries, in 2005, only 11% of HIV-positive pregnant women had access to treatment to reduce the risks of vertical HIV transmission. Internationally, targeted HIV prevention campaigns only reached 9% of men who have sex with men, 8% of injecting drug users, and less than a fifth of sex workers in 2005. Many governments favour general HIV awareness campaigns rather than initiatives targeting groups most at risk of infection. Only about 12% of men and 10% of women in high prevalence African countries have been tested for HIV. Although the report suggests male circumcision could help reduce new HIV infections by 8% by 2015, it warns no single prevention intervention can be 100% effective.

There has been a marked increase in global HIV spending in recent years, with projected spending in 2007 reaching $10 billion. However, the report notes that expenditure needs to more than double over the next three years to reach the UNAIDS target of $22 billion by 2010. Effective prevention would account for half of this money.