HIV prevention around the world

Africa is the continent worst affected by AIDS, and because most new infections occur during unprotected heterosexual sex, the main goal in HIV prevention is to persuade people to change their sexual behaviour – to delay first sex, decrease casual relationships, and increase condom use. This is always a difficult task, and in Africa it is made harder by poverty, lack of resources and weak infrastructure. Only around one in ten Africans has been tested for HIV and knows whether they are infected; misconceptions about transmission routes are widespread, and access to condoms is very low. As a result, most countries have yet to see any decline in their epidemics. However, a few notable exceptions prove that such declines are achievable.

Uganda

Of all African countries, Uganda has won the most praise for its HIV prevention efforts. The proportion of adults living with the virus fell from around 15% in the early 1990s to about 5% in 2001, and most experts believe this was largely because of concerted efforts to encourage safer sexual behaviour. The response began in the mid-1980s, and was characterised by strong political leadership, open communication and involvement of numerous grassroots organisations, as well as expanded condom distribution, HIV testing and treatment of sexually transmitted infections.
In recent years, HIV prevalence in Uganda has failed to decline further, and perhaps has increased slightly. A national survey in 2004-2005 found that around half of men and women did not use a condom the last time they had casual sex, and almost one in three said they had had more than one sexual partner during the previous year.¹⁶ The epidemic is still very severe and there is much room for improvement.