E-drug: Re: cheaper drugs and behaviour change (cont)
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A response from a colleague to the message from David Scondras:
The levelling off - and now fall - in prevalence rates of HIV in
Uganda - and in a few other countries - such as Senegal - is unlikely
to be simply a matter of behaviour change - nor simply a matter of "
the sexually active dying off" - Uganda never had high enough rates
to kill off their sexually active population! It is impossible to
know the weight to give to a variety of factors that must have
influenced the diminished transmission rates. They probably include
strains of the virus, genetic susceptibility of the population,
particular patterns of sexual networking, perhaps even the 'dying
off' of some of the most susceptible, but also - most certainly -
behaviour change as a result of the early and ongoing openness of
Museveni (and the fact that Ugandans had a leader they respected) -
resulting in less (not no) stigma, so that the reasonably good and
early access to VCT, information and condoms meant that many got
tested and had increased awareness and a desire to change behaviour -
the epidemic was well advanced in Uganda before it got to Zimbabwe
and South Africa - and people also changed behaviour out of fear - or
perhaps call it sense - when they could see so many of their peers
and relatives dying. Comparison with nearby countries does show that
a large part of the explanation is likely to be behaviour change.
Dr Wendy Holmes
Women and Childrens Health Specialist
International Health Unit
Macfarlane Burnet Centre for Medical Research
Fairfield 3078
Australia
holmes@burnet.edu.au
submitted by
Beverley Snell
International Health Unit, Macfarlane Burnet Centre for Medical Research
P O Box 254 Fairfield Vic Australia 3078
Telephone 613 9282 2115 / 9282 2275
Fax 613 9482 3123
Time zone: 10 hours ahead of GMT.
email <bev@burnet.edu.au>
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