Fear Battles Fatalism in Africa's AIDS Fight

Upwards of 5.6 million South Africans have HIV/AIDS. And in 2009, according to UNAIDS, 34 percent of the world's HIV-positive population lived in 10 countries in Southern Africa.

New data suggest that people in several countries are altering their sexual practices and substantially lowering infection statistics. However, 14 million South Africans collect government aid, and one-quarter are unemployed; some, therefore, risk unprotected sex for money.

Officials note the sex trade between truckers and prostitutes helped carry HIV throughout Southern Africa. Yet, regional new infection rates fell, and sub-Saharan Africa's HIV incidence decreased 25 percent between 2001 and 2009. "It's progress," said UNAIDS Deputy Director Paul de Lay. "But if it continues at this rate, then we are talking another 40 to 50 years ... until it gets down to the lowest levels."

Over the past decade, South Africa's government went from denying the efficacy of antiretrovirals in favor of purported vegetable remedies, to widely offering condoms, using the media to heighten public consciousness, and appropriating billions for treatment and prevention. According to de Lay, this momentum must be kept up because "new cohorts of young people [enter] into risk behavior every four or five years."

According to a study, "A Surprising Prevention Success: Why Did the HIV Epidemic Decline in Zimbabwe?" in PLoS Medicine, neighboring Zimbabwe reversed one of the world's worst epidemics and went from a 29 percent infection rate in 1997 to 16 percent in 2007. Study researcher Simon Gregson, of Imperial College-London, credited heightened awareness due to Zimbabwe's acute situation, "high levels of education and quite a strong marriage system."

Although awareness has increased in Nigeria, condom aversion and fatalism seem pervasive. "The men here have a lot of girlfriends and they use prostitutes," said Abdul Abdulkarim, who is 25 and single. "I don't think Nigerians really fear death."

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