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Main Findings:
There are clear prevention priorities
It is a fundamental responsibility of government to ensure that HIV is prevented among those with the riskiest behavior. (p. 39, 40, Chapter 2) Preventing infection among people with the riskiest behavior is essential to stopping the epidemic.
- Who has the riskiest behavior? People with who have unprotected sex with many partners and people who inject drugs and share unsterilized needles are most likely to become infected and to pass HIV to others. (pp. 77-85, especially the box on p. 82)
- Helping people who engage in the riskiest behavior to protect themselves and others will prevent the largest number of infections. A program in Nairobi, Kenya, demonstrates this point: The program treated the sexually transmitted diseases of 500 prostitutes and raised their condom use to 80 percent. It prevented 10,000 infections per year among the sex workers' clients, the clients' wives, and other partners. On the other hand, a similar level of condom use among an equal number of men in that community would have prevented fewer than 100 infections per year. (p. 83)
- Of course, sex workers and their clients are not the only people with risky behavior. The report gives examples of programs that have been effective among other groups, like injecting drug users (pp. 114-118) and truck drivers (p. 167).
The impact of 80 percent condom use in Nairobi
- The report finds that governments can be effective in promoting behavior change. And given the knowledge, means, and a supportive community, people with high-risk behavior do respond to protect themselves and others. (Chapter 3)
- In Thailand, a campaign to promote universal condom use in brothels has raised levels of condom use to over 90 percent. As a result, the number of patients with sexually transmitted diseases (STD), like gonorrhea and syphilis, has plummeted. In addition, the HIV infection rate among young army conscripts has dropped from 4 percent to less than 2 percent. (pp. 159, 160)
The impact of rising condom use in Thailand
(For more data, see the Statistical Appendix)
Next finding:
The World
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