In the period of Uganda's Zero Grazing campaign, the proportion of
Ugandan men and women with casual partners fell by 60 percent. On surveys
conducted throughout the country, most people said
that they were protecting themselves from HIV by reducing their partners
or "sticking
to one." By
the time the Zero Grazing campaign was replaced by the social marketing
of condoms in the early 1990s, the decline in the Ugandan HIV infection
rate had significantly progressed.
In the mid-1990s, with condoms proliferating throughout Uganda, the
proportion of men with "non-regular" partners
rose again, but HIV rates continued to fall, though more slowly.
After 2000, HIV rates rose slightly. Helen Epstein states her
belief that the reason HIV rates did not soar, even though more men
were having multiple partners, is because the men were using
condoms. She also believes that the reason HIV rates are no longer falling
is probably because men are not using condoms consistently, especially
in the longer-term, concurrent relationships where HIV transmission is
most likely to occur.
So why isn't Zero Grazing revived as a preventive policy to HIV?
Perhaps because there is no multimillion-dollar bureaucracy to support
it, as there are for condom promoters and abstinence-only educators.
Zero Grazing also acknowledges the existence of polygamy and long-term
established relationships with mistresses—something
that most of Western society has purged from the public "norm" since
the abolition of slavery.
The Zero Grazing strategy was
formulated by the Ugandans in the 1980s, when they were facing the
rampant decimation of their population to HIV/AIDS—and had no outside
assistance to deal with this—and were familiar with their own culture.
Now that AIDS
is a multibillion-dollar enterprise,
with vast budgets and eloquent consultants from Western nations offering
help to the overburdened health departments of Africa inundated by
the AIDS crisis, African health officials will understandably welcome
whatever help is available. This is where CHATA presents it's own unique
strategy of
enabling the culture to change from within. Possibly as revolutionary
as Uganda's Zero Grazing campaign.
^TOP UGANDA SUCCESS >
Tom Barton, "Epidemics and
Behaviours: A Review of Changes in Ugandan Sexual Behavior in the Early
1990s," unpublished report for UNAIDS, Geneva, 1997. Zero Grazing
may be a natural reaction to the threat of AIDS. Just as in Uganda, partner
reduction, combined with strategic, consistent condom use in casual relationships,
has been responsible for HIV declines in Thailand and in the gay community
throughout the developed world. See Susan Kippax and K. Race, "Sustaining
Safe Practice: Twenty Years On," Social Science and Medicine,
Vol. 57, No. 1 (July 2003), pp. 1–12; Daniel Low-Beer and Rand
L. Stoneburner, "Behaviour and Communication Change in Reducing
HIV: Is Uganda Unique?" African Journal of AIDS Research,
Vol. 2, No. 1 (2003), pp. 9–21; Martina Morris and Laura Dean,
"The Effect of Sexual Behavior Change on Long Term HIV Prevalence Among
Homosexual Men," American Journal of Epidemiology, Vol. 140
(1994), pp. 217–232.
www.nybooks.com/articles/17963 The
New York Review of Books, God and the Fight Against AIDS by Helen
Epstein
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