The U.S. Department of Defense (DOD) recently reported that its effort to help 29 sub-Saharan African nations' militaries develop HIV/AIDS prevention programs is showing signs of progress.

The best results are being achieved with prevention programs whose messages and issues are culturally relevant and applicable, said Dr. Rick Shaffer of the San Diego-based Naval Health Research Center, who directs the DOD's HIV/AIDS Prevention Program. "So we've found that what we've had to do is find those key cultural and military-specific issues that will both open the ears of a uniform-wearing member as well as make that uniform-wearing member think that somebody's taken the time to put together materials specifically for them."

The DOD program began four years ago and has since trained more than 2 million African military members, including 600 medical clinicians, and built 200 counseling and testing centers. The soldiers are typically 18- to 25-year-olds who have money and can travel. In many cases, the programs also serve the local off-base civilian population, said Shaffer.

Five years ago, few militaries in Africa had information about their HIV infection rate, said Shaffer. "Since that time we've been able to help currently between 12 and 15 militaries establish formal prevalence rates, whether it's been by force-wide surveillance or whether it's been by scientifically appropriate samples," said Shaffer. That's an important first step to gauge whether rates are declining, he added.

So far, the DOD initiative has measured a decline in HIV in Senegal's military, and it is starting to see some changes in the Ethiopian military's rate.

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