HIV / AIDS IN AFRICA UPDATE - 2001

Prevention of transmission

There are some signs that the number of new infections can be reduced. Such evidence comes from Uganda, a country with one of the older epidemics. Through strong prevention programmes, Uganda has brought down HIV incidence levels to about 8% from a peak of 14% in 1999.

Studies of recent trends in HIV infection in women attending antenatal clinics show a significant decline in HIV prevalence. For example in Nsambya Hospital, HIV prevalence rates fell from 30% in 1992 to 16.3% in 1997 and 12.4 % in 1999. This picture has also been repeated in the rural areas. The decline in HIV rates is most marked in young people aged 15-19 years.

In Uganda there is also a reported increase in knowledge on HIV/AIDS with at least two thirds of persons able to cite at least two acceptable methods of protection against HIV.  There is an increased proportion of sexually active persons who have ever used condoms. The percentage of young girls using condoms increased by three times between 1994 and 1997. Coupled with this is the reported increase in age at first sex, as well as a reduction in the number of sexual partners.

Most of the changes in Uganda have come about as a result of behavioral modifications in the general population through education of the general public. These findings suggest that the methods used to decrease HIV incidence are within the capacity of most other African countries.

Vaccines

There are also vaccine trials taking place in a number of countries, but the results of these are not expected for a few years. The first of these trials for Africa is due to start in March 2001.

Conclusions

The spread of HIV/AIDS in Africa has been relentless and shows no evidence of abating. With over 25 million people infected with HIV/AIDS by the end of 2000, the effects on African nations are going to be felt for years to come. Life expectancy in the most severely affected countries is going to be markedly reduced, and the gains of child survival programmes are going to be wiped out.

Despite the gloomy picture being painted about HIV/AIDS, encouraging evidence from Uganda shows that the HIV prevalence can be reduced substantially with vigorous and aggressive prevention programmes. At the same time, there are signs that HIV incidence in Africa has stabilized. However to conclude from stabilizing or declining prevalence that the HIV/AIDS epidemic has been conquered and that prevention efforts are no longer necessary will have tragic consequences for future generations.

Sources:

UNAIDS: Report on the Global HIV/AIDS Epidemic 2000
UNAIDS:AIDS Epidemic Update; December 2000
Population Reference Bureau
Country Reports on Health, Nutrition, Population, and Poverty
HIV Insite: AIDS in Sub Saharan Africa
Workshop on the Status and Trends of the HIV/AIDS Epidemics in Africa: Final Report
Uganda AIDS Commission: HIV/AIDS in Uganda: Summary of the situation, impact and national strategies, October 2000.
J.H.S Kiwanuka Ssemakula: HIV/AIDS & The Health Care System in Uganda (unpublished thesis Sept 1992)