A Surprising Prevention Success: Why Did the HIV Epidemic Decline in Zimbabwe?

• Published in: PLoS medicine Vol. 8; no. 2; p. e1000414
• Main Authors: Halperin, Daniel T., Mugurungi, Owen, Hallett, Timothy B., Muchini, Backson, Campbell, Bruce, Magure, Tapuwa, Benedikt, Clemens, Gregson, Simon
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 01.02.2011; Public Library of Science (PLoS)
• Subjects: Acquired immune deficiency syndrome; Africa, Southern - epidemiology; AIDS; Child welfare; Demographic aspects; Disease transmission; Economic indicators; Health behavior; HIV; HIV infection; HIV Infections - epidemiology; HIV Infections - prevention & control; Human immunodeficiency virus; Humans; Infectious Diseases/HIV Infection and AIDS; Mathematical models; Men; Mens health; Policy Forum; Prevention; Prevention programs; Public Health and Epidemiology/Global Health; Public Health and Epidemiology/Health Policy; Public Health and Epidemiology/Infectious Diseases; Risk factors; Sexual Behavior; Sexually transmitted diseases; Studies; Success; Zimbabwe - epidemiology; Africa, Southern; Zimbabwe; Thailand; Uganda; HIV Infections; Zimbabwe; Sexual Behavior; Africa, Southern; Humans
• ISSN: 1549-1676; 1549-1277; 1549-1676
• DOI: 10.1371/journal.pmed.1000414

The earlier successes in Thailand and Uganda may not be fully relevant to the severely affected countries of southern Africa. * We conducted an extensive multi-disciplinary synthesis of the available data on the causes of the remarkable HIV decline that has occurred in Zimbabwe (29% estimated adult prevalence in 1997 to 16% in 2007), in the context of severe social, political, and economic disruption. * The behavioral changes associated with HIV reduction--mainly reductions in extramarital, commercial, and casual sexual relations, and associated reductions in partner concurrency--appear to have been stimulated primarily by increased awareness of AIDS deaths and secondarily by the country's economic deterioration. [...]DHS data on various potential proximal and contextual determinants of behavior change for Zimbabwe were compared with similar data for seven other southern African countries to identify distinctive patterns that might help to explain the earlier and faster HIV decline observed in Zimbabwe (Figures 2, S1).