Thursday, December 04, 2003
As AIDS spreads, Uganda offers positive lesson
Reports from the United Nations in the past week have highlighted the continuing AIDS epidemic, which infected and killed more people than ever this year, spreading rapidly in eastern Europe and gaining a stronger foothold in India and China. Sub-Saharan Africa, where there are more than 11 million AIDS orphans, remains the worst-affected region, says the UN. But infection rates are falling in Uganda and Senegal, and for pregnant women in the capital cities of Rwanda and Ethiopia.
• Uganda is one of the world's earliest and best success stories in overcoming HIV/AIDS, according to a report from the United States Agency for International Development based on evidence presented by four individuals with long-term experience of HIV prevention in Africa. After spreading rapidly during the 1980s, HIV prevalence peaked at around 15 per cent in 1991 and had fallen to 5 per cent in 2001 - a unique phenomenon worldwide.
The report, What Happened in Uganda? says the decline came mainly from behavioural changes promoted by strong political leadership. There was an emphasis on abstinence in messages directed at youth, with the result that in one district the proportion of youths aged 13-16 who reported having sexual experience dropped from 60 per cent in 1994 to less than 5 per cent in 2001.
Condom promotion has played a lesser role, with the decline in transmission rates beginning well before the widespread promotion of condoms from about 1995. The most important factor in the decline of HIV incidence in Uganda appears to be a decrease in multiple sexual partnerships and networks. The lesson of Uganda, says the report, is that "sexual behaviour itself must change" in order for the incidence of HIV to change.
Reports from the United Nations in the past week have highlighted the continuing AIDS epidemic, which infected and killed more people than ever this year, spreading rapidly in eastern Europe and gaining a stronger foothold in India and China. Sub-Saharan Africa, where there are more than 11 million AIDS orphans, remains the worst-affected region, says the UN. But infection rates are falling in Uganda and Senegal, and for pregnant women in the capital cities of Rwanda and Ethiopia.
• Uganda is one of the world's earliest and best success stories in overcoming HIV/AIDS, according to a report from the United States Agency for International Development based on evidence presented by four individuals with long-term experience of HIV prevention in Africa. After spreading rapidly during the 1980s, HIV prevalence peaked at around 15 per cent in 1991 and had fallen to 5 per cent in 2001 - a unique phenomenon worldwide.
The report, What Happened in Uganda? says the decline came mainly from behavioural changes promoted by strong political leadership. There was an emphasis on abstinence in messages directed at youth, with the result that in one district the proportion of youths aged 13-16 who reported having sexual experience dropped from 60 per cent in 1994 to less than 5 per cent in 2001.
Condom promotion has played a lesser role, with the decline in transmission rates beginning well before the widespread promotion of condoms from about 1995. The most important factor in the decline of HIV incidence in Uganda appears to be a decrease in multiple sexual partnerships and networks. The lesson of Uganda, says the report, is that "sexual behaviour itself must change" in order for the incidence of HIV to change.
