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Hope that a vaccine against HIV may some day be a reality got a boost this month. Results from a modest trial conducted in Thailand showed that a vaccine created by combining two previously ineffective agents seems to prevent infection with the strain of HIV virus common in Thailand and South Asia around 30 percent of the time. No previous vaccine trial has shown any effectiveness at all, so by that measure, advocates say, a 30 percent result is pretty good. But many critics have come forward to warn against excess exuberance. The scientists involved in the study do not know why the combined agents were effective, and questions about the scientific rationale behind the study have been in the air since its launch.

The real concern in the wake of such news is that hope for a vaccine will have a negative impact on non-pharmaceutical prevention efforts. People may cease to employ common sense prevention tactics, such as decreasing concurrent partnerships and using condoms. There is also an issue of funding. The majority of HIV/AIDS funding from government and private donors go to treatment programs. This has had some very positive impacts. The number of people receiving HIV treatment has doubled in the last year alone. But the result of such strong treatment focus has been a general neglect of identifying and scaling behavioral prevention efforts that work. That is a shame, because there are some very simple, inexpensive initiatives that have shown some success. A study in Kenya conducted by UCLA’s Pascaline Dupas, for example, showed a decrease in risky behavior among teenage girls who were educated about the risks of having sex with older men. Keeping girls in school longer has also shown positive impact.

The take-away for donors? Science is still years, if not decades, from finding a vaccine that works 70 to 80 percent of the time. To make a real difference in the short term, we need to focus on behavioral prevention that works.

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