title: Local perceptions of the forms, timing and causes of behavior change in response to the AIDS epidemic in Zimbabwe.
abstract: Quantitative studies indicate that HIV incidence in Zimbabwe declined since the late 1990s, due in part to behavior change. This qualitative study, involving focus group discussions with 200 women and men, two dozen key informant interviews, and historical mapping of HIV prevention programs, found that exposure to relatives and close friends dying of AIDS, leading to increased perceived HIV risk, was the principal explanation for behavior change. Growing poverty, which reduced men's ability to afford multiple partners, was also commonly cited as contributing to reductions in casual, commercial and extra-marital sex. HIV prevention programs and services were secondarily mentioned as having contributed but no specific activities were consistently indicated, although some popular culture influences appear pivotal. This qualitative study found that behavior change resulted primarily from increased interpersonal communication about HIV due to high personal exposure to AIDS mortality and a correct understanding of sexual HIV transmission, due to relatively high education levels and probably also to information provided by HIV programs.
authors.affiliation: Zimbabwe Country Office, United Nations Population Fund, Harare, Zimbabwe.
authors.forename: Backson
authors.initials: B
authors.lastname: Muchini
authors.forename: Clemens
authors.initials: C
authors.lastname: Benedikt
authors.forename: Simon
authors.initials: S
authors.lastname: Gregson
authors.forename: Exnevia
authors.initials: E
authors.lastname: Gomo
authors.forename: Rekopantswe
authors.initials: R
authors.lastname: Mate
authors.forename: Owen
authors.initials: O
authors.lastname: Mugurungi
authors.forename: Tapuwa
authors.initials: T
authors.lastname: Magure
authors.forename: Bruce
authors.initials: B
authors.lastname: Campbell
authors.forename: Karl
authors.initials: K
authors.lastname: Dehne
authors.forename: Daniel
authors.initials: D
authors.lastname: Halperin
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000453:epidemiology / Q000517:prevention & control* / Q000523:psychology; D003469:Culture; D058872:Epidemics; D005260:Female; D017144:Focus Groups; D015658:HIV Infections / Q000453:epidemiology / Q000517:prevention & control* / Q000523:psychology; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008402:Mass Media; D010465:Perception; D036301:Qualitative Research; D012307:Risk Factors; D012309:Risk-Taking; D012725:Sexual Behavior; D012747:Sexual Partners / Q000523:psychology*; D012959:Socioeconomic Factors; D015030:Zimbabwe / Q000453:epidemiology
references.citation: Cent Afr J Med. 1994 Nov;40(11):294-9
references.pmid: 7859268
references.citation: Science. 2006 Feb 3;311(5761):664-6
references.pmid: 16456081
references.citation: Sex Transm Infect. 2002 Apr;78 Suppl 1:i40-6
references.pmid: 12083446
references.citation: Epidemics. 2009 Jun;1(2):108-17
references.pmid: 21352758
references.citation: Int J Epidemiol. 2010 Oct;39(5):1311-23
references.pmid: 20406793
references.citation: Cent Afr J Med. 1988 May;34(5):95-7
references.pmid: 3248306
references.citation: Soc Sci Med. 1998 Feb;46(3):321-30
references.pmid: 9460814
references.citation: Soc Sci Med. 1990;31(5):609-18
references.pmid: 2218643
references.citation: Stud Fam Plann. 1992 Nov-Dec;23(6 Pt 1):365-75
references.pmid: 1293860
references.citation: AIDS. 2007 Nov;21 Suppl 6:S81-6
references.pmid: 18032943
references.citation: Cent Afr J Med. 1989 Jan;35(1):306-9
references.pmid: 2743407
references.citation: J Acquir Immune Defic Syndr (1988). 1992;5(6):556-9
references.pmid: 1588490
references.citation: Int J Health Serv. 1991;21(1):143-56
references.pmid: 2004868
references.citation: AIDS Care. 1989;1(3):269-80
references.pmid: 2488289
references.citation: Cent Afr J Med. 1989 Nov;35(11):519-23
references.pmid: 2632004