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Setting new standards for targeted HIV prevention: the Avahan initiative in India
  1. Peter Piot
  1. Institute for Global Health, Imperial College London, UK
  1. Correspondence to Professor Peter Piot, Imperial College, 15, Prince's Gardens, London, SW7 1NA, UK; p.piot{at}

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This special issue provides a first round of analyses of various aspects of the work of Avahan—a groundbreaking HIV prevention initiative in India supported by the Bill and Melinda Gates Foundation.

While it is one of the largest programmes of its kind, Avahan is not the only, nor the first, HIV prevention programme with sex workers and other populations at high risk in Asia.1–3 For example, in Thailand and Cambodia, the national 100% condom campaigns were the main large-scale intervention leading to a countrywide decline of HIV. However, the Indian initiative is using a more comprehensive approach through powerful synergies between evidence informed strategy, community empowerment, structural interventions and business style management. In addition, and in contrast to traditional interventions with sex workers, it is rightly focussing on clients as well, not just on the sex workers. The project demonstrates in a convincing way that intensified HIV prevention with marginalised and often difficult to reach populations can be brought to a very large scale with high coverage and penetration of the interventions. It also shows the importance and power of local level data collection, at least at the district level, for meaningful results for programme management and steering.

Whereas its record on programme implementation is undisputable, it is probably too early to state with confidence that Avahan has had an …

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