Low Condom Use, Multiple Sex Partners, Low Levels of Male Circumcision, Main Factors Fueling Spread of HIV in Southern Africa, Report Says

Low condom use, multiple concurrent sex partners and low levels of male circumcision are fueling the spread of HIV in southern Africa, according to a report released Monday by the Southern African Development Community, Reuters Health reports. The report also identifies men's sexual attitudes and behaviors, intergenerational sex, and gender and sexual violence as factors in the spread of the epidemic (Quinn, Reuters Health, 8/14). Stigma and social factors, such as population mobility and wealth disparities, also are exacerbating the spread of the virus, according to the report, which was released at a three-day meeting of 38 experts on HIV prevention in high-prevalence countries in southern Africa (Xinhua/People's Daily, 8/15). According to the experts, behaviors commonly deemed risky, such as casual sex or sex with commercial sex workers, no longer are the main elements fueling the spread of HIV in the region (Reuters Health, 8/14). The report finds that people engaging in risky behaviors might be better at protecting themselves from transmission of the virus than people who are in longer-term relationships. The report also finds that "voluntary counseling and testing has not been shown to date to have as strong an impact on behavior change as previously hoped." It adds, "Counseling and testing is still very important, however, as an entry point for care and treatment."

Recommendations
The report calls on the promotion of delaying sex, reducing the number of sex partners and proper condom use to help decrease the number of new HIV cases, a model known as "DRC," IRIN News reports (IRIN News, 8/14). Abstinence-only programs might persuade young people to delay sex, but they do not have a "large impact on their lifetime risk of HIV infection once they start being sexually active," according to the report. In addition, the report calls on southern African leaders to prepare for programs to expand male circumcision, which studies have shown might reduce men's risk of contracting HIV (Reuters Health, 8/14). The meeting -- which was supported by organizations such as UNAIDS, the World Health Organization and UNICEF -- was held ahead of the SADC summit, which is scheduled for Thursday and Friday in Maseru, Lesotho (Xinhua/People's Daily, 8/15).

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