Population-level HIV declines and behavioral risk avoidance in Uganda.
Uganda provides the clearest example that human immunodeficiency virus (HIV) is preventable if populations are mobilized to avoid risk. Despite limited resources, Uganda has shown a 70% decline in HIV prevalence since the early 1990s, linked to a 60% reduction in casual sex. The response in Uganda appears to be distinctively associated with communication about acquired immunodeficiency syndrome (AIDS) through social networks. Despite substantial condom use and promotion of biomedical approaches, other African countries have shown neither similar behavioral responses nor HIV prevalence declines of the same scale. The Ugandan success is equivalent to a vaccine of 80% effectiveness. Its replication will require changes in global HIV/AIDS intervention policies and their evaluation.
Stoneburner
Rand L
RL
Population Health Evaluation Unit, Cambridge University, Cambridge, UK. randstoneburner@netzero.net
Low-Beer
Daniel
D
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D017280:Condoms; D004196:Disease Outbreaks; D005260:Female; D015658:HIV Infections / Q000453:epidemiology* / Q000517:prevention & control*; D006266:Health Education; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D015994:Incidence; D033181:Information Dissemination; D008297:Male; D008875:Middle Aged; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000453:epidemiology* / Q000517:prevention & control*; D015995:Prevalence; D040242:Risk Reduction Behavior; D012746:Sexual Abstinence; D012725:Sexual Behavior; D012944:Social Support; D014454:Uganda / Q000453:epidemiology