Reduction in HIV-1 incidence among rural Ugandans gives hope to other African...( m National Centre in HIV Epidemiology a...),Health

m National Centre in HIV Epidemiology and Clinical Research, Sydney, Australia, concludes: "It is now clear that there has been a measure of success, as indicated by declining HIV risk behaviours, prevalence, and probably incidence, in a few sub-Saharan countries. This should be seen as encouraging evidence that well-supported social and behavioural prevention works, and that sentinel surveillance, carefully interpreted, can provide information of the success or otherwise of intervention programmes. Nevertheless, ongoing high rates of HIV transmission across sub-Saharan Africa, even in the more successful countries such as Uganda, and in high-risk populations elsewhere, means that simple, affordable, and effective biomedical means of HIV prevention are desperately needed."

In a Viewpoint article (p 78), Justin Parkhurst from the London School of Hygiene and Tropical Medicine, UK, acknowledges the success of Uganda in slowing the prevalence of HIV/AIDS, but cautions against the use of exaggerated claims and the oversimplification of the Ugandan model. He concludes: "The use of selective evidence as the basis for policy recommendations can be misleading and counterproductive. Countries with HIV-1 prevalence rates of more than 30% (such as some in Southern Africa) would be wrong to assume that by simply copying a few obvious Ugandan government interventions, they can expect to see a two-thirds reduction in their HIV-1 prevalence rate. Although Uganda has indeed done much in its struggle against HIV/AIDS, and the Ugandan experience can provide valuable information to assist other nations in their prevention efforts, inappropriate recommendations based on poor interpretation of evidence must not be used as the basis for policy."

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Contact: Richard Lane
richard.lane@lancet.com
44-20-7424-4949
Lancet
4-Jul-2002

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