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The 130th Annual Meeting of APHA |
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The 130th Annual Meeting of APHA |
Edward C. Green, PhD, School of Public Health, Harvard University, 665 Huntington Ave., Boston, MA 02115-6021, 207-439-3745, egreendc@aol.com
In unprompted, open-ended questions about change in sexual behavior, Africans and others in populations of high HIV prevalence tend to report high levels of fidelity to their current partners, reduction in the number of sexual partners, delay of sexual debut (among youth), and abstinence from sexual activity if unmarried. Such "primary behavior change" is also reported in cohort studies as major forms of behavior change in countries where national HIV prevalence has stabilized, or declined (Uganda, Senegal, Zambia). Evidence is presented showing these data as well as evidence that faith-based organizations have a "comparative advantage" in promoting primary behavior change in Africa and elsewhere. It is hypothesized that primary behavior change may be among the most effective interventions aimed at general populations, at least in generalized epidemics such as those in sub-Saharan Africa and the Caribbean. Likewise, harm reduction interventions (condom promotion, treating STIs) may be the most effective interventions for high-risk groups wherever they are found, and in focused epidemics such as those in southeast Asia. Given the importance of primary behavior change in HIV reduction, faith-based organizations ought to be supported in promoting fidelity and abstinence (including delay of sexual debut). Faith-based organizations should also promote condom use if they wish to, but this should not be a condition of receiving donor funds for AIDS prevention.
Learning Objectives:
Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.