05/09/08

AFRICA:  HIV Funding Priority Shift Call

While two-thirds of global HIV infections occur in Africa, the evidence supporting many prevention strategies targeting the continent's generalized heterosexual epidemics is weak, according to a new study.

Investments in condom promotion, HIV testing, and vaccine research have had limited success, the authors contend. In nine southern African countries, more than 12 percent of adults are HIV-infected, and condom promotion has not had a measurable effect on new infections, their review of research found. Studies have not consistently shown testing prevents new HIV infections, and proof is minimal that treating other STDs does so.

But male circumcision studies have shown that the procedure reduces the risk of female-to-male infections by up to 60 percent, said lead author Dr. Daniel Halperin of Harvard University School of Public Health. In addition, programs to reduce the number of sexual partners played a role in reducing HIV rates in Uganda, Kenya, Zimbabwe, Cote d'Ivoire, and in urban Malawi and Ethiopia, he said.

Male circumcision and reducing multiple sexual partners should become cornerstones of prevention, the authors said. "We need a fairly dramatic shift in priorities, not just a minor tweaking," Halperin said.

The full report, "Reassessing HIV Prevention," was published in Science (2008;320(5877):749-750).

Source: BBC; Courtesy of the CDC National Center for HIV, STD, and TB Prevention