Ugandan “Miracle”?

Toronto’s Globe and Mail reports that the Ugandan “miracle” may not be so miraculous after all:

But several recent studies suggest it wasn’t ABC that turned Uganda
around at all. Instead, they indicate that the infection rate declined
sharply for the simple reason that hundreds of thousands of
HIV-infected people died.

“The Ugandan miracle is that a lot of people died and they’re not
there [to count],” said James Rwanyarare, a Kampala physician and
opposition political figure who worked with some of the first Ugandans
to publicly disclose their HIV-positive status.

Other new research suggests condoms, more than anything else, stopped
the spread of acquired immune deficiency syndrome. The research –in
particular a study presented in Boston in February that followed 10,000
adults in the Rakai district for a decade — ignited a storm of
controversy here.

…Yet researchers from Columbia University and Johns Hopkins University
found that “the single greatest factor” in the decline in the number of
HIV-infected people in Rakai was the premature deaths of those who were
infected earlier and subsequently died of AIDS. About 70 per cent more
people died of AIDS in each year of that decade than the number who
were newly infected.

…The U.S. study also found that although people reported a growing
number of sexual partners, and declining abstinence over the decade,
there was no corresponding increase in the number of new HIV infections.

In fact the prevalence rate fell. Participants in the study reported
more condom use, which the researchers believe offset their high-risk
sexual behaviour. But the researchers said the emphasis on abstinence
and fidelity did not appear to have had an impact.

If we’re basing our policy on AB and not C (which is arguably where the
United States would like to go [see the previous article]), what are we
in for?

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