HIV decline associated with behavior change in eastern Zimbabwe.
Few sub-Saharan African countries have witnessed declines in HIV prevalence, and only Uganda has compelling evidence for a decline founded on sexual behavior change. We report a decline in HIV prevalence in eastern Zimbabwe between 1998 and 2003 associated with sexual behavior change in four distinct socioeconomic strata. HIV prevalence fell most steeply at young ages-by 23 and 49%, respectively, among men aged 17 to 29 years and women aged 15 to 24 years-and in more educated groups. Sexually experienced men and women reported reductions in casual sex of 49 and 22%, respectively, whereas recent cohorts reported delayed sexual debut. Selective AIDS-induced mortality contributed to the decline in HIV prevalence.
Gregson
Simon
S
Department of Infectious Disease Epidemiology, Imperial College London, UK. Sajgregson@aol.com
Garnett
Geoffrey P
GP
Nyamukapa
Constance A
CA
Hallett
Timothy B
TB
Lewis
James J C
JJ
Mason
Peter R
PR
Chandiwana
Stephen K
SK
Anderson
Roy M
RM
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D015331:Cohort Studies; D017280:Condoms; D004196:Disease Outbreaks / Q000517:prevention & control; D004641:Emigration and Immigration; D005260:Female; D015658:HIV Infections / Q000453:epidemiology* / Q000401:mortality / Q000517:prevention & control / Q000635:transmission; D006801:Humans; D015994:Incidence; D008137:Longitudinal Studies; D008297:Male; D015995:Prevalence; D012309:Risk-Taking; D012725:Sexual Behavior; D012959:Socioeconomic Factors; D015030:Zimbabwe / Q000453:epidemiology