Seven Types of Evidence Consistently Explain the Dramatic 1990's Reduction of HIV Incidence in Uganda

new study of AIDS in Uganda published in the journal, Sexually Transmitted Infections, reports that people first reduced their premarital and extramarital sexual partners and later increased their use of condoms with non-marital partners, and that this combination led to a dramatic decrease in HIV transmission in the early 1990s. The study by research scientist Douglas Kirby Ph.D of ETR Associates examined seven different types of evidence showing how the reduction of HIV transmission was achieved in Uganda. URL: http://sti.bmj.com/cgi/reprint/84/Suppl_2/ii35

The evidence examined in this study included models of HIV prevalence and incidence, reports of behavior change in Ugandan newspapers, surveys with questions about behavior and perceptions of personal behavior change, reports on condom shipments to Uganda and historical documents describing the implementation of HIV prevention programs. Notably, all seven types of data produced consistent evidence that people in Uganda first reduced their number of sexual partners prior to or outside of long-term marital or cohabiting relationships. This broke up sexual networks. People then increased their use of condoms with non-marital and non-cohabiting partners. Thus, the dramatic success of Uganda in the early 1990s demonstrates that first reducing the number of sexual partners and constricting sexual networks and then increasing condom use and further reducing the chances of HIV transmission with remaining casual partners can be achieved in Africa and can dramatically reduce the sexual transmission of HIV in generalized epidemics.

Reports from this study include: A brief summary of the campaign to reduce HIV transmission in Uganda and its success; major findings that have policy implications for other countries with generalized epidemics; an in-depth analysis of the evidence for behavior change; an analysis of Uganda's HIV prevention efforts and other efforts affecting perceptions of HIV risk and behavior; and a detailed historical summary of events in Uganda that affected the epidemic. These reports are available free of charge at https://etr.org/uganda
(1) Dr Douglas Kirby is senior research scientist at ETR Associates, a nonprofit health education organization in Scotts Valley, California.

ETR Associates is committed to helping children, young people and adults and their families and communities to develop attitudes and behaviors that contribute to optimal health and well-being. Because the adoption of healthy attitudes and behaviors is complex and influenced by a multitude of personal and environmental factors, ETR Associates believes that a variety of efforts are needed encompassing both health education and health promotion interventions. ETR believe these efforts should be based on sound research and evaluation. Founded in 1981, ETR Associates is a private, non-profit corporation located in Scotts Valley, California.

For more information, contact Dr. Douglas Kirby at dougk@etr.org

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