The spread and effect of HIV-1 infection in sub-Saharan Africa.
Africa is the continent most severely affected by the global HIV-1 epidemic, with east and southern Africa in general more severely affected than west and central Africa. Differences in the spread of the epidemic can be accounted for by a complex interplay of sexual behaviour and biological factors that affect the probability of HIV-1 transmission per sex act. Sexual behaviour patterns are determined by cultural and socioeconomic contexts. In sub-Saharan Africa, some traditions and socioeconomic developments have contributed to the extensive spread of HIV-1 infection, including the subordinate position of women, impoverishment and decline of social services, rapid urbanisation and modernisation, and wars and conflicts. Populations in many parts of Africa are becoming trapped in a vicious circle as the HIV-1 epidemic leads to high mortality rates in young and economically productive age groups, and thus leads to further impoverishment. Interventions to control HIV-1 should not only target individuals, but also aim to change those aspects of cultural and socioeconomic context that increase the vulnerability to HIV-1 of people and communities.
Buvé
Anne
A
Department of Microbiology, Institute of Tropical Medicine, Antwerp, Belgium. abuve@itg.be
Bishikwabo-Nsarhaza
Kizito
K
Mutangadura
Gladys
G
D000293:Adolescent; D000328:Adult; D017954:Africa South of the Sahara / Q000453:epidemiology; D017280:Condoms / Q000706:statistics & numerical data; D004196:Disease Outbreaks; D005260:Female; D015658:HIV Infections / Q000191:economics / Q000453:epidemiology / Q000635:transmission; D015497:HIV-1; D006801:Humans; D008297:Male; D011203:Poverty; D011247:Pregnancy; D015995:Prevalence; D012725:Sexual Behavior