International perspectives on individual and community approaches to the prevention of sexually transmitted disease and human immunodeficiency virus infection

Risks for sexually transmitted disease (STD) and human immunodeficiency virus (HIV) infection have been addressed in two categories: the individual and the population. Emphasis in STD and HIV prevention has largely been placed on the first, with interventions that address individuals and attempt to bring about changes in individuals being the norm. The relative ease of evaluating these interventions and the ability to know that they have been delivered as intended make these interventions attractive. Community interventions are more difficult to manage and to evaluate but are nonetheless commonly used. Structural interventions that address the environment in which risk behavior takes place are also possible but used much less frequently. In a comprehensive intervention program for STD and HIV prevention, it is necessary to consider opportunities for all three types of intervention approaches.