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When I began my career as an HIV activist in Botswana two decades ago, the thought of a vaccine seemed fanciful.These are challenging times in the global effort to end HIV.In 2017, there were 1.8 million new cases, and some 15.2 million people were unable to access HIV treatment.This history suggests that even with a vaccine, many complex social, economic and cultural issues will continue to complicate the war on HIV. We must think carefully about how to introduce a vaccine without unintentionally encouraging "rebound effects," like the re-emergence of practices that expose people to HIV infection.A similar behavioral shift in response to an HIV vaccine could be devastating. In many parts of the world, condom provision is in decline, while some individuals – like sex workers, drug users and members of the LGBT community – have difficulty accessing HIV-prevention services, owing to legal restrictions or discriminatory practices. No matter what becomes of this latest vaccine-related discovery, the world will still have a long way to go before HIV is eradicated.
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