The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #72220

Daniel T. Halperin, PhD, Office of HIV-AIDS, US Agency for International Development, 1300 Pennsylvania Ave., Global Health 5.10-023 RRB, Washington, DC 20523-3700, 202-712-4529, dhalperin@usaid.gov, Ruth Bessinger, PhD, MEASURE Evaluation, Macro International, 11785 Beltsville Dr, Calverton, MD 20705, Nomi Fuchs, MPH, Office of Population and Reproductive Health, USAID, 1300 Pennsylvania Ave., 3.06-041U, Washington, DC 20523, Edward C. Green, PhD, Harvard Center for Population and Development Studies, Harvard University, 9 Bow Street, Cambridge, MA 02138, Vinand Nantulya, MD, PhD, Policy and Evaluation, Global Fund for AIDS, Tuberculosis, and Malaria, Avenue Louis-Casai 53, 1216, Cointrin, Geneva, Switzerland, and Karen A. Stanecki, MPH, International Programs Center, US Census Bureau, Population Division, Washington, DC, DC 20233-8860.

This study analyzes to what extent and how "ABC" behaviors (Abstinence/delay of sexual onset, Being faithful/partner reduction, Condom use) have affected HIV prevalence in countries that have experienced a significant decline in HIV prevalence, compared with some other countries that have not. Background: There has been little significant decline of HIV prevalence in Africa or other developing regions, with the exception of Uganda, Thailand, and perhaps Cambodia and among youth in urban Zambia. Identifying which factors influenced a decline in HIV transmission in those countries with successful prevention experiences will help USAID and other donors determine effective interventions to prevent AIDS/STDs. Key Questions: 1) In three relatively successful countries (Thailand, Uganda, Zambia), which changes in sexual behavior appear to have contributed to declines in HIV, compared with three countries (Cameroon, Kenya, Zimbabwe) where prevalence has not decreased? 2) Can specific policy and/or program interventions be linked to such behavior changes? Methodology: Comparative analysis of trends in sexual behavior in and across the six countries, based on DHS and other quantitative and qualitative data sources. Preliminary Findings: Abstinence/delay of sex and partner reduction appear to be important determinants of prevalence reduction in the high-prevalence generalized epidemics. For example, according to GPA surveys in Uganda -- where fidelity/"Zero Grazing" was a key message -- approximately 10% of adults in 1995 reported a casual sexual partner, down from 30% in the 1989 survey. Increased condom use with non-regular partners was also significant in these and, especially, in the more concentrated, lower-prevalence Thailand epidemic.

Learning Objectives:

Attendees will learn about:
• What the available data suggests have been the main behavioral determinants underlying the relatively few developing country "success stories" in HIV prevention,
• The main policy and programmatic approaches associated with these more successful national prevention experiences, and
• How the different "ABC" messages and approaches have been promoted, and have interacted with one another, in more as well as less successful AIDS prevention programs.

Keywords: Epidemiology, HIV Interventions

Related Web page: www.synergyaids.com/show.asp?id=3750&type=18

Awards: Excellence in Abstract Submission on an International Topic--Award Winner - Winner

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.