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HIV Decline Associated with Behavior Change in Eastern Zimbabwe
Simon Gregson,1,2*Geoffrey P. Garnett,1Constance A. Nyamukapa,2Timothy B. Hallett,1James J. C. Lewis,1Peter R. Mason,2Stephen K. Chandiwana,2,3Roy M. Anderson1
Few sub-Saharan African countries have witnessed declines inHIV prevalence, and only Uganda has compelling evidence fora decline founded on sexual behavior change. We report a declinein HIV prevalence in eastern Zimbabwe between 1998 and 2003associated with sexual behavior change in four distinct socioeconomicstrata. HIV prevalence fell most steeply at young ages—by23 and 49%, respectively, among men aged 17 to 29 years andwomen aged 15 to 24 years—and in more educated groups.Sexually experienced men and women reported reductions in casualsex of 49 and 22%, respectively, whereas recent cohorts reporteddelayed sexual debut. Selective AIDS-induced mortality contributedto 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
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REPORTS
John Stover, Stefano Bertozzi, Juan-Pablo Gutierrez, Neff Walker, Karen A. Stanecki, Robert Greener, Eleanor Gouws, Catherine Hankins, Geoff P. Garnett, Joshua A. Salomon, J. Ties Boerma, Paul De Lay, and Peter D. Ghys (10 March 2006) Science311 (5766), 1474.
[DOI: 10.1126/science.1121176] |Abstract »|Full Text »|PDF »|Supporting Online Material »
PERSPECTIVES
Richard Hayes and Helen Weiss (3 February 2006) Science311 (5761), 620.
[DOI: 10.1126/science.1124072] |Summary »|Full Text »|PDF »
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