Huge decline in HIV rates in Zimbabwe driven by fear of infection, says study

Feb 08, 2011

The big drop in the numbers of people infected with HIV in Zimbabwe is because of mass social change, driven by fear of infection, according to an international study reported today in the journal PLoS Medicine. The scientists unravelling the reasons behind this unexpected downturn now reveal what they hope are the most important lessons in the fight against the disease for the rest of Africa.

Zimbabwe's epidemic was one of the biggest in the world until the number of people infected with HIV in Zimbabwe almost halved, from 29% to 16%, between 1997 and 2007. Remarkably, this occurred against a background of massive social, political, and economic disruption in the country.

Today's findings strongly show that people in Zimbabwe have primarily been motivated to change their sexual behaviour because of improved public awareness of deaths and a subsequent fear of contracting the virus. The researchers found that other important drivers have been the influence of education programmes that have shifted people's attitudes towards having multiple concurrent sexual partners in extramarital, commercial and casual relations and that have increased the acceptability of using condoms for casual sex.

Professor Simon Gregson, from the School of Public Health at Imperial College London, and senior investigator on the study, said: "Given the continuing, and worrying, trend for high HIV/AIDS infection rates in many sub-Saharan African countries, we felt it was important to understand why the disease has taken a such a dramatic downturn in Zimbabwe. Very few other countries around the world have seen reductions in , and of all African nations, Zimbabwe was thought least likely to see such a turnaround. This is why there was such an urgent need to understand its direct and underlying causes."

Dr Timothy Hallett, also from the School of Public Health at Imperial College London and an investigator on the study, said: "The HIV epidemic is still very large, with more than one in ten adults infected today. We hope that Zimbabwe - and other countries in southern Africa - can learn from these lessons and strengthen programs to drive infections down even further."

The scientists say a change in peoples' attitudes towards their numbers of partners was aided by HIV/AIDS prevention programs organised by the National AIDS Council through the mass media and church-based, workplace-based, and other interpersonal communication activities. The unfavourable economic situation in Zimbabwe from the early 2000s would also have driven down the number of concurrent partners a man could have, due to the constraints on his wallet, but occurred after behaviour had begun to change and would be unlikely to have altered his attitude towards infection. Other underlying factors found to distinguish Zimbabwe from neighbouring countries, and which may have contributed to the changes in behaviour, included its well-educated population and strong traditions of marriage.

The researchers reached their overall conclusions after investigating the results of studies from the last twenty years, which were also considered at a national meeting in the Zimbabwean capital, Harare, in 2008. Several other factors affecting HIV/AIDS infection were also discussed, including the age at which people first engaged in , the introduction of HIV counselling and testing services, and transmission of the virus through means other than sex, such as blood transfusion and needle sharing. However these were ruled out following close examination of the medical and programme evidence.

The results of this study have been extensively and openly debated at the national meeting in Zimbabwe, where attendees reached a 'clear consensus' about the legitimacy of the findings. The researchers hope that, by making the data available more widely, the conclusions of the study can now be judged by other policy makers in the international community and that a clear message can be agreed about the factors driving a decline in /AIDS.

Some of the studies upon which this paper is based were funded by the United Nations Population Fund (UNFPA), which provided some logistical support as well as helping with coordination between the studies. The United Nations HIV-AIDS Program (UNAIDS) and the Zimbabwean Ministry for Health and Child Welfare sponsored this study, along with funding from the Wellcome Trust.

Explore further: Indiana HIV outbreak, hepatitis C epidemic sparks US alert

More information: "A Surprising Prevention Success: Why Did the HIV Epidemic Decline in Zimbabwe?" PLoS Medicine 8(2): e1000414. doi:10.1371/journal.pmed.1000414

Related Stories

Researchers: Zimbabwe's crisis driving HIV decline

Jul 24, 2009

(AP) -- Fewer Zimbabweans are getting infected with AIDS, and researchers speculate it's due in part to a battered economy that's leaving men short of money to be sugar daddies and keep mistresses.

Recommended for you

Indiana HIV outbreak, hepatitis C epidemic sparks US alert

Apr 24, 2015

Federal health officials helping to contain an HIV outbreak in Indiana state issued an alert to health departments across the U.S. on Friday, urging them to take steps to identify and track HIV and hepatitis C cases in an ...

Why are HIV survival rates lower in the Deep South than the rest of the US?

Apr 22, 2015

The Deep South region has become the epicenter of the US HIV epidemic. Despite having only 28% of the total US population, nine states in the Deep South account for nearly 40% of national HIV diagnoses. This region has the highest HIV diagnosis rates and the highest number of people living with HIV of any ...

A bad buzz: Men with HIV need fewer drinks to feel effects

Apr 20, 2015

Researchers at Yale and the VA Pittsburgh Healthcare System compared the number of drinks that men with HIV infection, versus those without it, needed to get a buzz. They found that HIV-infected men were more sensitive to ...

User comments : 0

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.