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Falling HIV rates tell complex story
02 August 2007
PlusNews
When it comes to sub-Saharan Africa's devastating AIDS crisis, there is an understandable tendency to latch onto any scrap of good news.
Figures suggesting the epidemic is waning in some countries are being trumpeted by governments and international donor agencies as evidence that their prevention efforts are succeeding.
Kenya's National AIDS Control Council recently ascribed a small drop in the country's HIV infection rate to people absorbing the messages in awareness campaigns and changing their behaviour accordingly.
South Africa's health minister, Manto Tshabalala-Msimang, claimed that the first evidence of declining HIV prevalence in pregnant women - from 30.2 percent in 2005 to 29.1 percent in the latest survey - was mainly due to "our continued focus on prevention as the mainstay of our response to combat HIV".
But the real story behind increases and decreases in HIV prevalence is far less clear. "There's an awful lot of vested interests, but it's sufficiently murky that no one really knows what's going on," Prof John Hargrove, director of the Centre of Excellence in Epidemiological Modelling and Analysis (SACEMA) at the University of Stellenbosch, South Africa, told IRIN/PlusNews.
Twenty-five years is not long to get to grips with an epidemic that has evolved very differently in different parts of the world: in Europe, North America and Asia it has largely been confined to high-risk groups like injecting drug users, sex workers and men who have sex with men; in southern Africa it has spread rapidly via heterosexual networks.
Although theories abound, "nobody really knows why southern Africa is worst affected", said Dr Brian Williams, another epidemiologist at SACEMA. "And if we don't know that, it's very difficult to explain why prevalence is going up or down."
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