July 7, 2010
A month-long period of sexual abstinence could be a viable cultural approach to stopping new HIV infections, two epidemiologists suggest. During that month, new HIV transmissions could be cut by up to 45 percent in countries such as Swaziland, South Africa, and Zimbabwe, according to Alan Whiteside, of the University of KwaZulu-Natal, and Justin Parkhurst, of the London School of Hygiene and Tropical Medicine. The researchers noted that a newly infected person can most readily spread HIV in the first month after acquiring the virus.
Low HIV prevalence in predominantly Muslim nations has previously been credited to universal male circumcision. However, Whiteside also observed that the practices of some religious groups are protective. Muslim men, for instance, are taught to abstain from alcohol, male-to-male sex, and extramarital sex. In Zimbabwe, the Marange Apostolic sect bans sex during Passover and has a lower infection rate than surrounding communities.
"We have this idea that we are going to put everyone on treatment. That is actually pretty fanciful," said Whiteside. "A month of abstinence or condom use is far less difficult to achieve."
"This kind of initiative could provide hyper-endemic countries with a one-off, short-term adaptation that is cost-effective, easy to monitor, and does not create additional stigma," Whiteside said. "The main thing is to agree on a bounded period in which the entire population would live by the same rule."
"We see this kind of initiative as a way of breaking the cycle," said Derek von Wissell, director of Swaziland's National Emergency Response Council on HIV/AIDS. "We think a good month to do it would be during the southern African spring, in October or November."