AEGiS-13IAC: Analyses of HIV trend and behavioral data in Uganda, Kenya, and Zambia: prevalence declines in Uganda relate more to reduction in sex partners than condom use.

13th International AIDS Conference

Durban, South Africa - July 9-July 14, 2000

Analyses of HIV trend and behavioral data in Uganda, Kenya, and Zambia: prevalence declines in Uganda relate more to reduction in sex partners than condom use.

Int Conf AIDS 2000 Jul 9-14; 13:(abstract no. ThOrC721)

Stoneburner R
R. Stoneburner, Corpus Partners Ltd, 4 Chemin des Cotes, 1297 Founex, Switzerland, Tel.: +41 22 776 85 22, Fax: +41 22 776 87 14, E-mail: StoneburnerR@WHO.CH

BACKGROUND: To perform analyses of HIV trend and behavioral data from countries in East and Southern Africa. To test the hypothesis that HIV prevalence declines in Uganda are unique and associated with different levels of AIDS attitudes and behaviors.

METHODS: We analyzed HIV prevalence at ANC surveillance sites between 1990-98 in Uganda (14 sites, N = 19,676); Kenya (7, N = 38,031); Zambia (22, N = 30,488); and Malawi (20, N = 23,561), and examined AIDS behavioral data from DHS performed in Uganda (1995), Kenya (1998), and Zambia (1996).

RESULTS: From 1990-98, HIV prevalence rates declined significantly (p > .05) overall and in 15-24 y/o in 79% (11/14) of sites in Uganda. Overall, Uganda ANC prevalence declined from 21.1% in 1991 to 9.7% in 1998, with declines in ages 15-19 & 20-24 from 21 % to 25 % and 5% to 11% in 1991-98. In contrast, ANC rates in other countries were unchanged or increased, with rare exceptions. Overall, in Kenya, ANC prevalence increased from 14 % to 19%, from 1994-98; in Zambia, rates were 19.1% in 1994 and 19.2% in 1998. ANC rates in urban Lusaka, were 23.7% in 1994 and 27.1% in 1998, despite prevalence declines in 15-19 y/o from 27.2% to 14.8% (p > .05). There were differences (p > .05) in behavioral data in Uganda vs. Kenya & Zambia, respectively: > = 1 sex partner outside of regular in 12 mo., 5.1% vs.22.2%; condom use in last partner outside regular, 10.9% vs. 45%; ever use condom, 16% vs.25%; know someone with AIDS; 90.1% vs.70.8%. Differences varied by gender.

CONCLUSIONS: HIV declines in Uganda are not evident in other countries. Behavior in Uganda reveal less sex partners outside of spouse, less use of condoms, and greater personalization of AIDS risk. The intervention in Uganda has had a different impact - this has implications for improving efficacy of HIV intervention strategies

Keywords: AEGIS, Prevalence, Sexual Partners, Safe Sex, HIV Infections, HIV Seropositivity, Condoms, Acquired Immunodeficiency Syndrome, Uganda, Kenya, Zambia, Research, Africa, Southern, Malawi, epidemiology, trends
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ThOrC721