Africa: the Enormous Challenges of a Long-lasting Epidemic (HIV)

Member since February 12, 2014
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The African countries south of the Sahara have some of the best HIV surveillance systems in the world. They provide solid evidence that the HIV infection rate has stabilized at a relatively low level in Senegal and that the extremely high rates in Uganda have been reduced. However, in most sub-Saharan countries adults and children are acquiring HIV at a higher rate than ever before: the number of new infections in the region during 1999 was 4.0 million. This acceleration effect is yet another challenge posed by long-standing epidemics. As the rate of HIV infection in the general population rises, the same patterns of sexual risk result in more new infections simply because the chances of encountering an infected partner become higher.

In Zambia, the Government has been trying to involve all sectors in HIV prevention, from health to education, agriculture and industry. Religious leaders and church groups have also been playing a part in prevention. New data from Zambia’s HIV sentinel surveillance system … show that the percentage of pregnant girls aged 15–19 infected with HIV in the capital, Lusaka, has on average dropped by almost half in the last six years.

Comparisons between studies of sexual behaviour conducted in 1990, 1992, 1996, and 1998 suggest that these falling HIV rates are due in part to a decrease in the prevalence of some types of risky sexual behaviour in urban areas. For example, far fewer young women in Lusaka were having sex before marriage in 1996 than in 1990, and the percentage of unmarried women who were sexually active fell from 52% to 35% over that period. Among young men, according to nationwide studies, the change came later; in 1998 just over half of unmarried men said they had not had sex in the past year, compared with just over a third two years earlier, and the proportion of men reporting two or more casual partners in the past year also fell. However, there was no evidence at the national level that either girls or boys were postponing the start of their sex life.

Elsewhere in the region too, there are signs that young people are avoiding the patterns of behaviour which led their parents and older siblings to such high levels of HIV infection.

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