Study Challenges Abstinence as Crucial to AIDS Strategy
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Thursday, February 24, 2005
UGANDA:
"Study Challenges Abstinence as Crucial to AIDS Strategy"
New York Times (02.24.05): Lawrence K. Altman
Wednesday at the 12th Conference on Retroviruses and Opportunis-
tic Infections in Boston, researchers presented a study finding
no evidence that abstinence and monogamy explained the overall
falling HIV seroprevalence in a Uganda district, though cam-
paigns touting them may have contributed to the decline. Ugan-
dan, Columbia University and John Hopkins University scientists
collaboratively conducted the study.
In the 1994-2002 study conducted in 44 communities in Rakai,
Uganda, researchers determined the number of men having two or
more non-marital sex partners significantly increased. Sexual
abstinence remained constant. Annually, the number of people
with HIV who died exceeded the number who acquired the virus by
about 70. During the study period, condom use by men with their
most recent non-marital sex partner increased substantially,
said Dr. Maria J. Wawer of Columbia's Mailman School of Public
Health. Wawer added that "condoms are essential" in preventing
AIDS.
The study by Wawer and colleagues included 10,000 people ages
15-49, with an 85-90 percent rate of participation. The findings
apply to Rakai and cannot be extrapolated to other Uganda re-
gions, said Wawer and a coauthor, Dr. Ronald Gray of Johns Hop-
kins' Bloomberg School of Public Health. One reason is that the
age of sexual debut varies by region.
Three earlier national surveys conducted at five-year intervals
- which suggested delayed sexual debut among many Ugandans - in-
volved smaller sample sizes in districts that varied with each
survey, limiting their accuracy in comparison with the Rakai
study.
The study findings emphasize that "condoms are the main preven-
tive tool against HIV," said Dr. Chris Beyrer, director of the
Fogarty International Training and Research Program at JHBSPH.
"Condoms have to be everywhere alcohol and sex are sold," said
Beyrer.
Why monogamy and abstinence did not play a larger role in the
decline may be due to message fatigue and treatment optimism
among residents, said Wawer. The Bush administration, Ugandan
President Yoweri Museveni and some public health experts have
credited Uganda's HIV decline to the ABC prevention strategy
(Abstinence, Being monogamous, and Condom use).
--
Leela McCullough, Ed.D.
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