Low condom use blamed in Southern Africa AIDS crisis
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Southern Africa’s AIDS pandemic, the world’s worst, is being fueled primarily by low condom use among people with multiple concurrent sexual partners and low levels of male circumcision, a new study said on Monday.
The report by the Southern African Development Community (SADC) said men’s sexual attitudes and behaviors, intergenerational sex and high levels of gender and sexual violence also were to blame for the rapid spread of the disease.
It urged regional leaders—often accused of moving too slowly against the AIDS crisis—to encourage condom use and the reduction of the number of multiple sexual partners, as well as prepare for the possible roll-out of programs to expand male circumcision as a bulwark against HIV infection.
Southern Africa is at the epicenter of Africa’s AIDS epidemic, with an average adult HIV prevalence rate estimated at 11 percent compared to one percent globally.
The region which includes South Africa, the continent’s economic powerhouse, is estimated to be home to about 40 percent of all people living with HIV globally. It accounted for 37 percent of all new infections in 2005.
The SADC report, compiled after a meeting of regional experts, said the AIDS epidemic was being worsened by the stigma around HIV as well as social factors, including high population mobility, which make it easy for the virus to travel.
Gender inequality also plays a dangerous role, leaving young women—already biologically more vulnerable to infection—particularly at risk in unequal sexual and social relationships.
‘HIGH RISK’ ACTIVITIES NO LONGER TO BLAME
The SADC experts said that traditionally “high risk” activities such as casual sex and sex with prostitutes were no longer the principal cause of new infections in the region.
Instead, people with networks of concurrent sexual relationships who are unlikely to consistently use condoms were creating fertile ground for the virus.
“Huge numbers of people may be at risk of HIV infection if only one person in the sexual network is newly infected,” the report said.
The meeting noted a recent study in South Africa which appeared to indicate that male circumcision could effectively prevent some HIV infections by removing foreskins, which are at a cellular level more susceptible to HIV.
“Male circumcision is a one-off intervention conferring lifelong reduced biological risk to HIV,” the report said.
But it stopped short of echoing calls from some activists for an immediate escalation of circumcision programs, saying more evidence was needed and that circumcision must first be made safe and affordable.
The report also cast doubt on programs that urge sexual abstinence, which it said might persuade young people to delay their first sexual experience but “does not have a large impact on their lifetime risk of HIV infection once they start being sexually active”.
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