Note to users. If you're seeing this message, it means that your browser cannot find this page's style/presentation instructions -- or possibly that you are using a browser that does not support current Web standards. Find out more about why this message is appearing, and what you can do to make your experience of our site the best it can be.

Science 3 February 2006:
Vol. 311. no. 5761, pp. 664 - 666
DOI: 10.1126/science.1121054
Prev | Table of Contents | Next

Reports

HIV Decline Associated with Behavior Change in Eastern Zimbabwe

Simon Gregson,1,2* Geoffrey P. Garnett,1 Constance A. Nyamukapa,2 Timothy B. Hallett,1 James J. C. Lewis,1 Peter R. Mason,2 Stephen K. Chandiwana,2,3 Roy M. Anderson1

Few sub-Saharan African countries have witnessed declines in HIV prevalence, and only Uganda has compelling evidence for a decline founded on sexual behavior change. We report a decline in HIV prevalence in eastern Zimbabwe between 1998 and 2003 associated with sexual behavior change in four distinct socioeconomic strata. HIV prevalence fell most steeply at young ages—by 23 and 49%, respectively, among men aged 17 to 29 years and women aged 15 to 24 years—and in more educated groups. Sexually experienced men and women reported reductions in casual sex of 49 and 22%, respectively, whereas recent cohorts reported delayed sexual debut. Selective AIDS-induced mortality contributed to the decline in HIV prevalence.

1 Department of Infectious Disease Epidemiology, Imperial College London, UK.
2 Biomedical Research and Training Institute, Harare, Zimbabwe.
3 Faculty of Health Sciences Research and Postgraduate Studies, University of Witwatersrand, Johannesburg, Republic of South Africa.

* To whom correspondence should be addressed. E-mail: Sajgregson{at}aol.com

Read the Full Text


THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES:
Is sexual risk taking behaviour changing in rural south-west Uganda? Behaviour trends in a rural population cohort 1993-2006.
S Biraro, L A Shafer, I Kleinschmidt, B Wolff, A Karabalinde, A Nalwoga, J Musinguzi, W Kirungi, A Opio, J Whitworth, et al. (2009)
Sex Transm Inf 85, i3-i11
   Abstract »    Full Text »    PDF »
Influence of timing of sexual debut and first marriage on sexual behaviour in later life: findings from four survey rounds in the Kisesa cohort in northern Tanzania.
B Zaba, R Isingo, A Wringe, M Marston, E Slaymaker, and M Urassa (2009)
Sex Transm Inf 85, i20-i26
   Abstract »    Full Text »    PDF »
Measuring trends in age at first sex and age at marriage in Manicaland, Zimbabwe.
I Cremin, P Mushati, T Hallett, Z Mupambireyi, C Nyamukapa, G P Garnett, and S Gregson (2009)
Sex Transm Inf 85, i34-i40
   Abstract »    Full Text »    PDF »
Role of widows in the heterosexual transmission of HIV in Manicaland, Zimbabwe, 1998-2003.
B A Lopman, C Nyamukapa, T B Hallett, P Mushati, N S.-d. Preez, F Kurwa, M Wambe, and S Gregson (2009)
Sex Transm Inf 85, i41-i48
   Abstract »    Full Text »    PDF »
Comparative assessment of the quality of age-at-event reporting in three HIV cohort studies in sub-Saharan Africa.
A Wringe, I Cremin, J Todd, N McGrath, I Kasamba, K Herbst, P Mushore, B Zaba, and E Slaymaker (2009)
Sex Transm Inf 85, i56-i63
   Abstract »    Full Text »    PDF »
Trends in marriage and time spent single in sub-Saharan Africa: a comparative analysis of six population-based cohort studies and nine Demographic and Health Surveys.
M Marston, E Slaymaker, I Cremin, S Floyd, N McGrath, I Kasamba, T Lutalo, M Nyirenda, A Ndyanabo, Z Mupambireyi, et al. (2009)
Sex Transm Inf 85, i64-i71
   Abstract »    Full Text »    PDF »
Reported number of sexual partners: comparison of data from four African longitudinal studies.
J Todd, I Cremin, N McGrath, J-B Bwanika, A Wringe, M Marston, I Kasamba, P Mushati, T Lutalo, V Hosegood, et al. (2009)
Sex Transm Inf 85, i72-i80
   Abstract »    Full Text »    PDF »
Parents' and teachers' communication about HIV and sex in relation to the timing of sexual initiation among young adolescents in Tanzania.
K. Kawai, S. F. Kaaya, L. Kajula, J. Mbwambo, G. P. Kilonzo, and W. W. Fawzi (2008)
Scand J Public Health 36, 879-888
   Abstract »    PDF »
Fewer partners or more condoms? Modelling the effectiveness of STI prevention interventions.
G P Garnett, P J White, and H Ward (2008)
Sex Transm Inf 84, ii4-ii11
   Abstract »    Full Text »    PDF »
Discrepancies between UN models and DHS survey estimates of maternal orphan prevalence: insights from analyses of survey data from Zimbabwe.
L Robertson, S Gregson, C Madanhire, N Walker, P Mushati, G Garnett, and C Nyamukapa (2008)
Sex Transm Inf 84, i57-i62
   Abstract »    Full Text »    PDF »
Measuring effectiveness in community randomized trials of HIV prevention.
T. Hallett, G. Garnett, Z Mupamberiyi, and S Gregson (2008)
Int. J. Epidemiol. 37, 77-87
   Abstract »    Full Text »    PDF »
HIV incidence in 3 years of follow-up of a Zimbabwe cohort--1998-2000 to 2001-03: contributions of proximate and underlying determinants to transmission.
B. Lopman, C. Nyamukapa, P. Mushati, Z. Mupambireyi, P. Mason, G. P Garnett, and S. Gregson (2008)
Int. J. Epidemiol. 37, 88-105
   Abstract »    Full Text »    PDF »
Critique of early models of the demographic impact of HIV/AIDS in sub-Saharan Africa based on contemporary empirical data from Zimbabwe.
S. Gregson, C. Nyamukapa, B. Lopman, P. Mushati, G. P. Garnett, S. K. Chandiwana, and R. M. Anderson (2007)
PNAS 104, 14586-14591
   Abstract »    Full Text »    PDF »
Evaluating the proximate determinants framework for HIV infection in rural Zimbabwe.
J. J C Lewis, C. A Donnelly, P. Mare, Z. Mupambireyi, G. P Garnett, and S. Gregson (2007)
Sex Transm Inf 83, i61-i69
   Abstract »    Full Text »    PDF »
Appropriate evaluation of HIV prevention interventions: from experiment to full-scale implementation.
T. B Hallett, P. J White, and G. P Garnett (2007)
Sex Transm Inf 83, i55-i60
   Abstract »    Full Text »    PDF »
Behaviour change in generalised HIV epidemics: impact of reducing cross-generational sex and delaying age at sexual debut.
T B Hallett, S Gregson, J J C Lewis, B A Lopman, and G P Garnett (2007)
Sex Transm Inf 83, i50-i54
   Abstract »    Full Text »    PDF »
Declining HIV Prevalence in Zimbabwe.
(2006)
AIDS Clinical Care 2006, 6
   Full Text »
Less High-Risk Sex = Less HIV.
(2006)
Journal Watch Infectious Diseases 2006, 3
   Full Text »


To Advertise     Find Products

Science. ISSN 0036-8075 (print), 1095-9203 (online)