Sexual Abstinence Behind Uganda's AIDS Success Story

Stephen Mbogo | Correspondent | Monday, January 13, 2003

Sexual Abstinence Behind Uganda's AIDS Success Story

Nairobi, Kenya ( - Some experts say the dramatic drop in HIV/AIDS infections in Uganda is proof that abstinence from sex is the best way to combat the deadly disease, especially in the world's hardest-hit area, sub-Saharan Africa.

Infections in the East African country, which once had the highest rate in the world, have dropped from 30 percent of the population in the early 1990s to around 10 percent today.

Although promotion of condom use has been a part of Uganda's HIV/AIDS prevention
strategy, the concept of "True Love Awaits" - an abstinence-until-marriage program launched in 1994 and supported by schools and religious organizations - is credited with bringing down the infection rate.

"Abstinence remains the best strategy, especially for the risk group aged 15-25 years," said Dorothy Kwenze, an HIV/AIDS activist in neighboring Kenya. "The concept has worked well for Uganda and can equally work for other African countries."

According to a study by development experts Rand Stoneburner, Uganda's prevention model, used elsewhere, has the potential to reduce the AIDS rate in Africa's worst-stricken countries by 80 percent.

Stoneburner, a former Centers for Disease Control and Prevention and World Health Organization (WHO) epidemiologist, says that is the same level of efficacy one might expect from an HIV vaccine.

Uganda boasts the most successful HIV/AIDS prevention case in Africa to date, as it is the only country in sub-Saharan Africa where the incidence of HIV/AIDS has decreased substantially.

Credit is partly attributed to President Yoweri Museveni, who came to power in 1986, restored political stability, and led an aggressive anti-AIDS campaign by encouraging HIV-testing, abstinence and the use of condoms.

His government also invested heavily in training health workers, creating counseling networks and treating sexually transmitted diseases.

"President Museveni has made it a point to speak out about AIDS at every opportunity, and he has made all of his ministers, not just his health minister, responsible and accountable for results," U.S. Secretary of State Colin Powel said on World Aids Day last year.

Powell said countries having the most success in the fight against AIDS were those whose leaders had been the most forthcoming about the disease, and who made sure that lifesaving information reached all of their people.

Promotion of condom use is generally pushed by U.N. agencies, population control advocates and others, as the most effective way to combat AIDS.

Reports by the Johns Hopkins School of Public Health argue that the Uganda success story was partly due to use of condoms.

On the other hand, Dr. Vinand Nantulya, an infectious disease specialist who helped advise Museveni, said Ugandans "really never took to condoms."

The message that took hold was that young people, who are at a higher risk of being
infected, should not have sex until marriage and then remain faithful to their single partner.

The results, when they came, were remarkable by any measure. By 2001, the number of pregnant Ugandan women testing positive for HIV had fallen from 21.2 percent at the height of the epidemic in 1991 to 6.2 percent.

By contrast, in Kenya the rate in 2001 was roughly 15 percent of pregnant women, while in Zimbabwe it stands at 32 percent and in Botswana at 38 percent of mothers-to-be. Rates continue to rise in each country.

In some African countries, life expectancy has dropped over a single decade by as much as 10 years.

Current estimates by UNAIDS, the United Nations AIDS agency, are that more than four million people are infected in sub-Saharan Africa while adult prevalence
rate is 9 percent.

In Zambia, for instance, it dropped from 52 years in 1990 to 40.5 years in 2000, according to the U.N. Children Fund. One in five Zambians are infected.

The worst countries are believed to be Swaziland, where 38.6 percent of adults have HIV - a jump of four points in just one year - and Botswana, where the 38.8 percent of the adult population is infected.

UNICEF spokesman Marc Vergara said recently the deepening levels of poverty in Africa are eroding families' ability to cope with the AIDS crisis.

Extended families. which in the past took care of orphaned children, are no longer able to do so.

In the sprawling city of Soweto outside Johannesburg, South Africa, it's reported that funeral directors are now holding services on weekdays because their schedules on the weekends - the traditional day to bury loved ones - are overbooked.

Elsewhere in South Africa, in parts of Kwazulu-Natal province, AIDS victims are being buried upright because of a shortage of space in cemeteries.

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