New Study: Uganda’s HIV incidence drops due to condoms, not abstinence or faithfulness
From the San Francisco Chronicle:
In the Rakai district … researchers found that abstinence and
fidelity have actually been declining, but the expected rise in HIV infections
stemming from such behavior has not occurred.
“Condom use may be offsetting other high-risk behaviors,” said Maria
Wawer, a professor at Columbia University’s Mailman School of Public Health,
who presented the study at a session of the 12th Annual Retrovirus Conference
in Boston.
Ominously, Uganda is now in the midst of an acute condom shortage,
according Wawer, who conducts research in the Rakai district, one of the
earliest locations of the AIDS epidemic in Africa.
Researchers from John Hopkins, Columbia and Ugandan institutions
returned to the very studied southern Rakai district on Lake Victoria,
following the same cohort of approximately 10,000 study participants
over a 10 year period, collecting self reported behaviors and biologic
samples of urine and blood.
The report also has implications for longstanding family planning
programs. There is an interesting carry-over from the pre-HIV era
of continued hormonal contraceptive methods. Zimbabwe for
instance began a family planning effort in 1967 and the continued use
of the pill and a low condom use rate today is due in part to those
early programming decisions. In the era of HIV, late-coming
national family planning programs are benefiting from a surge in
barrier methods promotion. Uganda’s contraceptive prevalence data
bear this up: less than 3% of married women 15-49 years old used any
modern contraceptive method in 1988. By 2001, that proportion had
risen to 18.2%. The dual benefits are plain to see; although
Uganda’s total fertility remains very high, it has fallen from 7.4 to
6.9 children per woman and HIV incidence rate has dropped to under 10%
per year from over 30% 15 years ago.
Filed under: Epidemiology