What part of HIV prevention conversations don't we understand?

There has been much discussion, particularly in the wake of analyses of the World Health Organization's 3 by 5 programme, about the place of prevention in responses to HIV. While 3 by 5 focussed on improved access to treatment for people living with HIV and AIDS, its successor 'Universal Access' explicitly acknowledged that if we are to make any significant impact on the HIV pandemic then programme scale-up must include prevention and care. HIV prevention is not just about minimising the risk of disease transmission from an infected individual to another. As HIV is transmitted in our communities, we must also consider how we minimise the burden of HIV that weighs upon infected people. Edwin Cameron's recent book, Witness to AIDS, while not directly about prevention, illustrates some of the dimensions that can be overlooked when we do not stop to think and reflect on the dynamics involved in the conversations we have about preventing HIV.