HIV/AIDS is robbing sub-Saharan Africa of potential economic gains by
decimating whole populations. According to UNAIDS/WHO AIDS Epidemic
Update: December 2005, sub-Saharan Africa is home to more than 60
percent of all HIV/AIDS victims—around 25.8 million people, and
growing. In three African nations: Kenya, Uganda and Zimbabwe, "declines
in adult national HIV prevalence appear to be under way," the U.N.
report states. "East Africa continues to provide the most hopeful
indications that serious AIDS epidemics can be reversed," it reported,
with "the countrywide drop in HIV prevalence among pregnant women—seen
in Uganda since the mid-1990s—now being mirrored in urban parts
of Kenya, where infection levels are dropping, in some places quite steeply." Uganda's
HIV prevalence rate now is estimated to be around 7 percent, one of the
lowest in Africa.
The AIDS epidemic in Kenya peaked in the late 1990s with an overall
HIV prevalence of 10 percent in adults, which declined to 7 percent in
2003, the U.N. report said. The "most dramatic drops in prevalence
have been among pregnant women in urban areas—especially in Busia,
Meru, Nakaru and Thika, where median HIV prevalence plummeted from approximately
28 percent in 1999 to 9 percent in 2003.
Significantly, the U.N. report emphasized that "In both countries,
behavioral changes are likely to have contributed to the trend shifts."
The report says, "Recent data from Zimbabwe's national surveillance
system show a decline in HIV prevalence among pregnant women from 26
percent in 2002 to 21 percent in 2004. In Harare, HIV prevalence
in women attending antenatal or postnatal clinics fell from 35 percent
in 1999 to 21 percent in 2004. In rural eastern Zimbabwe, declines
in HIV prevalence in pregnant women were also reflected in declines
among both men and women in the general population."
"In Uganda, in 1991, a multisectoral program began, including
condom distribution and promotion involving popular songs and drama groups,
counseling, and support services. In 1995 a nationwide promotion campaign
started—with songs and soap operas, drama, posters, and other approaches
promoting safe sex, abstinence, fewer sex partners, and condom use among
young people. There was a subsequent rise in age at first sexual intercourse
and in monogamy and a decrease in HIV prevalence, especially among young
people. The percentage of pregnant women with HIV has dropped since 1991,
based on blood tests at five sites. The use of condoms has increased
substantially among young people. Among men ages 15 to 19, the percentage
who had ever used condoms rose from 20 percent in 1989 to about 60 percent
in 1995."
In 2005, researchers from Columbia University who have been studying
the epidemic in Rakai district for more than a decade have claimed that
the HIV decline in Uganda was due to a large number of deaths from AIDS
and to a lesser extent, to an increase in the use of condoms.
In a rebuttal, a number of evangelical Christians and African traditionalists
have argued that the HIV decline in Uganda was due to increased sexual
abstinence and faithfulness in marriage, arising from a remarkable commitment
to Christian values, and a return to African traditions that cherished
virginity.
However, a sober review of AIDS research over the past 20 years suggests
that both parties in this debate may be off the mark. Research findings
point to two types of behavior change as the main causes of the HIV decline
in Uganda. The first was a 60 percent reduction in the proportion of
men and women with casual sexual partners (meaning relationships lasting
less than a year) in the late 1980s and early 1990s. These changes were
promoted by campaigns urging people to "love carefully" and to "zero-graze"
and were reinforced by the threatening sounds of drums on radio and TV,
and an effectively executed public health program that delivered the
message throughout the country.
Research does show that boys and young men of the current generation
in Uganda are less polygamous and more cautious with sex. This brings
us to the current situation in Uganda. There is recent evidence which
indicates that HIV prevalence is no longer on the decline and, may be
increasing in some parts of the country, particularly among adults in
their 30s.
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http://usinfo.state.gov/gi/Archive/2005/Nov/25-438271.html
"Condom promotion works,"
Johns Hopkins University, at: http://www.jhuccp.org/pr/h9/h9chap7_4.stm
Lawrence Altman, "Study Challenges
Abstinence as Crucial to AIDS Strategy," The New York Times, February
24, 2005 ; and David Brown, "Uganda's AIDS Decline Attributed
to Deaths," The Washington Post, February 24, 2005.
http://www.bioline.org.br/request?hp05001
Wakabi, W. (2006). Condoms still
contentious in Uganda's struggle over AIDS. Lancet, 367, 1387-1388.
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