AIDS and Behavior

, Volume 13, Issue 3, pp 409-413

First online:

Open Access This content is freely available online to anyone, anywhere at any time.

Family Wellness, Not HIV Prevention

  • Mary Jane Rotheram-BorusAffiliated withGlobal Center for Children and Families, University of California Email author 
  • , Dallas SwendemanAffiliated withGlobal Center for Children and Families, University of California
  • , Diane FlanneryAffiliated withGlobal Center for Children and Families, University of California


HIV exceptionalism (and disease-specific programs generally) garner both unbalanced funding and the most talented personnel, distorting local health priorities. In support of HIV exceptionalism, the successful mobilization of significant global health sector resources was not possible prior to HIV. Both sides of the debate have merits; rather than perpetuating polarization, we suggest that sustained improvements in global health require creating a prevention infrastructure to meet multiple health challenges experienced by local communities. We propose four fundamental shifts in HIV and disease prevention: (1) horizontally integrating prevention at one site locally, with priorities tailored to local health challenges and managed by local community leaders; (2) using a family wellness metaphor for services, not disease prevention; (3) implementing evidence-based prevention programs (EBPP) based on common principles, factors, and processes, rather than replication of specific programs; and (4) utilizing the expertise of private enterprise to re-design EBPP into highly attractive, engaging, and accessible experiences.


HIV prevention Disease-specific programs Families Chronic illness management Global health