The AIDS epidemic is sweeping sub-Saharan Africa at an alarming rate.  However there are exceptions to the trend.  The number of AIDS sufferers in both rural and urban areas of Uganda has been falling since the mid-1990s.Is the tide beginning to turn against the AIDS epidemic?  Are AIDS awareness campaigns successful in changing sexual behaviour?  The Uganda Virus Research Institute studied levels of HIV in rural Uganda over a period of 10 years.  The study provided the first evidence of falling levels of new cases of HIV in a rural African population. 

Levels of HIV infection are also falling in Senegal and Zambia and amongst certain groups of the population in Kenya and in the People’s Republic of Congo.  These reductions are believed to be due to the success of campaigns promoting safer sexual behaviour. However the number of people infected with HIV in a region is affected by several factors, including mortality rates and the number of immigrants arriving and emigrants leaving the area of infection. A more reliable measure identified is the number of new cases of HIV that occur in a geographical area over a given time period.

The study, which took place in the rural Masaka district of Uganda, found that:

• the number of adults who have become infected with HIV has fallen considerably over the 10 year period
• the decline in new cases of HIV is amongst all groups of the population, both men and women, and older and younger adults
• over the 10 years, the percentage of women aged 20 to 24 who tested HIV-positive has fallen from 21 per to 8 per cent. Women aged 40 to 44 who are HIV-positive has fallen from 10 per cent to 5 per cent
• women aged between 35 and 44 are more likely to have HIV than before.  Many of these women were infected when they were young and before the safe sex campaigns were introduced.

There has been a fall in the levels of HIV amongst members of the fifteen villages of Masaka that took part in the survey.  The most likely reason is that people are changing their behaviour.  They are beginning to practise safe sex as a result of the severity of the epidemic and the health education campaigns run by the government and in the media.  The evidence from this study gives hope that the HIV/AIDS awareness campaigns to practise safe sex are an effective weapon in the fight against HIV/AIDS.

Source(s):
‘HIV-1 epidemic trends in rural south-west Uganda over a 10-year period', Tropical Medicine and International Health 7(12): 1047-1052, by J.A.G. Whitworth et al, 2002
'Declining HIV-1 incidence and associated prevalence over 10 years in a rural population in south-west Uganda: a cohort study', Lancet 360: 41-46, by S.M. Mbulaiteye et al, 2002
'Fighting HIV/AIDS: is success possible?', Bulletin of the WHO 79: 1113-1120, S. Okware et al, 2001

Funded by: UK Medical Research Council

id21 Research Highlight: 9 May 2003

Further Information:
Jimmy Whitworth
London School of Hygiene and Tropical Medicine
Keppel Street
London
WC1E 7HT
UK

Fax: +44 (0)20 7299 4632
Contact the contributor: jimmy.whitworth@lshtm.ac.uk

Ugandan Virus Institute and Medical Research Council HIV/AIDS Research Unit

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'Teaching HIV a lesson - a link between education and the AIDS virus?'

'Is awareness enough? Practical responses the HIV epidemic in southern Africa'

'Film, book or play? Community-based HIV prevention in rural Uganda'

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