Uganda's HIV success has more to do with condoms than abstinence

Although Uganda's much-touted "ABC (Abstinence, Be Faithful, use Condoms)" HIV prevention effort has gained favor in the Bush administration due to its encouragement of abstinence, a new study shows that the country's success in lowering HIV infection rates is due mostly to condom usage, The New York Times reports. A study of about 10,000 people ages 15-49 in 44 communities in Uganda showed no evidence that abstinence and monogamy were related to the falling HIV prevalence rate in the region, according to researchers from Uganda, Johns Hopkins University, and Columbia University. In the 1994-2002 study, abstinence and monogamy actually decreased among Ugandan men, with the number of men reporting two or more nonmarital partners significantly increasing during the course of the study. But condom use by the men with their most recent nonmarital sex partner also increased, leading to the lower HIV transmission rates, according to the study. The researchers were unclear why abstinence and monogamy didn't play a greater role in the declining HIV infection rate, but they theorize that abstinence-message fatigue and optimism over the success of anti-HIV drugs may have contributed to the findings. Although the researchers say the study's findings apply only to the specific communities studied because sexual activity varies by region in Uganda, they still say the research proves that "condoms are essential" in preventing HIV transmissions, according to Columbia researcher Maria J. Wawer. Chris Beyrer, director of the Fogarty International Training and Research Program at Johns Hopkins, told the Times that "condoms are the main preventive tool against HIV. Condoms have to be everywhere alcohol and sex are sold."