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Changes in sexual behaviour leading to the decline in the prevalence of HIV in Uganda: confirmation from multiple sources of evidence.

Kirby D - Sex Transm Infect (2008)

Bottom Line: To identify the changes in sexual behaviour that led to the dramatic reduction in the prevalence of HIV in Uganda in the early 1990s.Seven different types of evidence were examined: (1) models of HIV prevalence and incidence in Kampala and other sentinel sites in Uganda; (2) reports of behaviour change in the primary newspaper in Uganda; (3) surveys with questions about perceptions of personal behaviour change; (4) large demographic and health surveys (DHS) collected in 1988/9 and 1995 and large Global Program on AIDS (GPA) surveys in 1989 and 1995 with questions about reported sexual behaviour; (5) smaller less representative surveys of reported sexual behaviour collected in other years; (6) reports of numbers of condoms shipped to Uganda; and (7) historical documents describing the implementation of HIV prevention programmes in Uganda.All seven types of data produced consistent evidence that people in Uganda first reduced their number of sexual partners prior to or outside of long-term marital or cohabiting relationships, and then increased their use of condoms with non-marital and non-cohabiting partners.

View Article: PubMed Central - PubMed

Affiliation: ETR Associates, 4 Carbonero Way, Scotts Valley, CA 95066-4200, USA. dougk@etr.org

ABSTRACT

Objectives: To identify the changes in sexual behaviour that led to the dramatic reduction in the prevalence of HIV in Uganda in the early 1990s.

Methods: Seven different types of evidence were examined: (1) models of HIV prevalence and incidence in Kampala and other sentinel sites in Uganda; (2) reports of behaviour change in the primary newspaper in Uganda; (3) surveys with questions about perceptions of personal behaviour change; (4) large demographic and health surveys (DHS) collected in 1988/9 and 1995 and large Global Program on AIDS (GPA) surveys in 1989 and 1995 with questions about reported sexual behaviour; (5) smaller less representative surveys of reported sexual behaviour collected in other years; (6) reports of numbers of condoms shipped to Uganda; and (7) historical documents describing the implementation of HIV prevention programmes in Uganda.

Results: All seven types of data produced consistent evidence that people in Uganda first reduced their number of sexual partners prior to or outside of long-term marital or cohabiting relationships, and then increased their use of condoms with non-marital and non-cohabiting partners.

Conclusions: Consistent with basic theories about transmission of sexually transmitted infections, first reducing the number of sexual partners and breaking up sexual networks and then reducing the chances of HIV transmission with remaining casual partners by using condoms can be achieved and can dramatically reduce the sexual transmission of HIV in generalised epidemics.

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Number of condoms (in millions) received in Uganda from different organisations by year. DFID, Department for International Development; FPIA, Family Planning International Association; IPPF, International Planned Parenthood Federation; KFW, Kreditanstalt für Wiederaufbau/MBZ; PSI, Population Services International; UNFPA, United Nations Population Fund; USAID, United States Agency for International Development; WHO, World Health Organization.
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U9G-84-S2-0035-f02: Number of condoms (in millions) received in Uganda from different organisations by year. DFID, Department for International Development; FPIA, Family Planning International Association; IPPF, International Planned Parenthood Federation; KFW, Kreditanstalt für Wiederaufbau/MBZ; PSI, Population Services International; UNFPA, United Nations Population Fund; USAID, United States Agency for International Development; WHO, World Health Organization.

Mentions: According to these data, relatively few condoms were received in Uganda before 1989 (fig 2). In 1989 about 15 million condoms were received, in 1991 and 1992 about 12 million, and in nearly every subsequent year the number exceeded 20 million and grew rapidly.


Changes in sexual behaviour leading to the decline in the prevalence of HIV in Uganda: confirmation from multiple sources of evidence.

Kirby D - Sex Transm Infect (2008)

Number of condoms (in millions) received in Uganda from different organisations by year. DFID, Department for International Development; FPIA, Family Planning International Association; IPPF, International Planned Parenthood Federation; KFW, Kreditanstalt für Wiederaufbau/MBZ; PSI, Population Services International; UNFPA, United Nations Population Fund; USAID, United States Agency for International Development; WHO, World Health Organization.
© Copyright Policy - openaccess
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2602746&req=5

U9G-84-S2-0035-f02: Number of condoms (in millions) received in Uganda from different organisations by year. DFID, Department for International Development; FPIA, Family Planning International Association; IPPF, International Planned Parenthood Federation; KFW, Kreditanstalt für Wiederaufbau/MBZ; PSI, Population Services International; UNFPA, United Nations Population Fund; USAID, United States Agency for International Development; WHO, World Health Organization.
Mentions: According to these data, relatively few condoms were received in Uganda before 1989 (fig 2). In 1989 about 15 million condoms were received, in 1991 and 1992 about 12 million, and in nearly every subsequent year the number exceeded 20 million and grew rapidly.

Bottom Line: To identify the changes in sexual behaviour that led to the dramatic reduction in the prevalence of HIV in Uganda in the early 1990s.Seven different types of evidence were examined: (1) models of HIV prevalence and incidence in Kampala and other sentinel sites in Uganda; (2) reports of behaviour change in the primary newspaper in Uganda; (3) surveys with questions about perceptions of personal behaviour change; (4) large demographic and health surveys (DHS) collected in 1988/9 and 1995 and large Global Program on AIDS (GPA) surveys in 1989 and 1995 with questions about reported sexual behaviour; (5) smaller less representative surveys of reported sexual behaviour collected in other years; (6) reports of numbers of condoms shipped to Uganda; and (7) historical documents describing the implementation of HIV prevention programmes in Uganda.All seven types of data produced consistent evidence that people in Uganda first reduced their number of sexual partners prior to or outside of long-term marital or cohabiting relationships, and then increased their use of condoms with non-marital and non-cohabiting partners.

View Article: PubMed Central - PubMed

Affiliation: ETR Associates, 4 Carbonero Way, Scotts Valley, CA 95066-4200, USA. dougk@etr.org

ABSTRACT

Objectives: To identify the changes in sexual behaviour that led to the dramatic reduction in the prevalence of HIV in Uganda in the early 1990s.

Methods: Seven different types of evidence were examined: (1) models of HIV prevalence and incidence in Kampala and other sentinel sites in Uganda; (2) reports of behaviour change in the primary newspaper in Uganda; (3) surveys with questions about perceptions of personal behaviour change; (4) large demographic and health surveys (DHS) collected in 1988/9 and 1995 and large Global Program on AIDS (GPA) surveys in 1989 and 1995 with questions about reported sexual behaviour; (5) smaller less representative surveys of reported sexual behaviour collected in other years; (6) reports of numbers of condoms shipped to Uganda; and (7) historical documents describing the implementation of HIV prevention programmes in Uganda.

Results: All seven types of data produced consistent evidence that people in Uganda first reduced their number of sexual partners prior to or outside of long-term marital or cohabiting relationships, and then increased their use of condoms with non-marital and non-cohabiting partners.

Conclusions: Consistent with basic theories about transmission of sexually transmitted infections, first reducing the number of sexual partners and breaking up sexual networks and then reducing the chances of HIV transmission with remaining casual partners by using condoms can be achieved and can dramatically reduce the sexual transmission of HIV in generalised epidemics.

Show MeSH
Related in: MedlinePlus