08 July 2004 Blog Home : July 2004 : Permalink
Kathryn Lopez at the NRO gives the good news that Uganda's AIDS/HIV infection rates have dropped dramatically. She seems to believe this is not due to condoms but to behaviour change. I suggest that this is not an either/or situation. What has happened in Uganda, and in no other developing country that I am aware of - certainly no African one, is that the government got serious about explaining exactly how AIDS spreads.
In the rest of Africa utterly bogus explanations about the cause and (lack of) cure for AIDS abound and there is no simple official message. Indeed in countries such as Zimbabwe the government seems to prefer embarassed silence and denial that the sex-trade exists to any explanation what so ever. In such cases it is not surprising that a generally poorly educated population will tend to believe whatever crackpot urban legend they can.
It is surely the widespread information and education that has caused the reduction in AIDS. Explaining to the entire population that promiscuity and particularly unprotected promiscuous sex will give you AIDS and that you will die as a result since there is no cure. OF course this means behaviour change but condom usage is of itself a behaviour change. The result is that the prostitutes insist on condoms because they have the knowledge to make the informed choice that extra money for unprotected sex today will lead to premature death tomorrow. Likewise users of prostitutes can also debate whether slight additional pleasure is worth the risk of death.
What works is information and removing the taboo of discussing sex combined with providing the means to avoid the consequences of "slips from grace". Pretending that good people will not "slip" and that only "criminals" or "delinquants" will is preceisely what causes people to try and hide their condition and most-likely spread the disease.