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New sex study

by Paul King Saturday, Apr. 05, 2003 at 12:27 AM

A UK funded trial aimed at reducing the spread of Aids in Uganda by modifying sexual behaviour appears to have had little discernible effect.

Sex And HIV: Behaviour-Change Trial Shows No Link

The East African (Nairobi)

March 17, 2003

Posted to the web March 19, 2003

By Paul Redfern, Special Correspondent

Nairobi

A UK funded trial aimed at reducing the spread of Aids in Uganda by

modifying sexual behaviour appears to have had little discernible

effect.

The trial, carried out on around 15,000 people in the Masaka region,

involved distributing condoms, treating around 12,000 victims of

sexually transmitted diseases and counselling.

However, while the trial led to a marked change in sexual behavioural

patterns, with the proportion reporting causal sexual partners falling

from around 35 per cent to 15 per cent, there was no noticeable fall

in the number of new cases of HIV infection, although there was a

significant reduction in sexually transmitted diseases such as

syphilis and gonorrhoea.

The trial results, which were reported in the British medical journal

The Lancet, have already aroused some controversy.

The team leader of the trial, Dr Anatoli Kamalai, acknowledged that

there was "no measurable reduction" in HIV incidence with "no hint of

even a small effect."

But the research team's view is that the spread of HIV was already

declining in the area and the trial might not have been big enough to

detect any additional change.

There is, however, another view which has recently been put forward

which claims that inadequately sterilised needles across Africa have

led to a greater rate of HIV infection than sexual contact.

It is a view put forward by a mainly American group of scientists,

including Dr David Gisselquist, who told the Times of London that

"Results from the Masaka study add to the already long list of

findings from other studies that don't fit the hypothesis that most

HIV in African adults is from sexual transmission.

"These results from Masaka are similar to results published earlier

from a similar study in Rakai, Uganda, where interventions that

reduced STD prevalence had no impact on HIV incidence." However, such

a view is by no means mainstream in the latest thinking on the spread

of HIV in Africa.

Most scientific research still believes that HIV is mainly spread by

sexual transmission and that people suffering from STDs are

particularly prone.

The trial was the first systematic attempt on a large scale to assess

whether modifying sexual behaviour and better management of other

sexual diseases could cut the transmission of HIV in Africa.

In a commentary in The Lancet, Judith Stephenson and Frances Cowan of

the Royal Free and University College Medical School in London

acknowledged that "many people will be disappointed by the lack of

reduction in HIV incidence, despite an apparently appropriate

intervention that reduced other STDs and was implemented on a huge

scale with great care and commitment."

The two researchers suggest that it might have been "the right trial

and the wrong time" - when HIV incidence was falling and when there

were already substantial reductions in risk behaviour.

Copyright © 2003 The East African. All rights reserved. Distributed

by AllAfrica Global Media (allAfrica.com).

http://allafrica.com/stories/200303190482.html

http://allafrica.com/stories/printable/200303190482.html

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LATEST COMMENTS ABOUT THIS ARTICLE
Listed below are the 10 latest comments of 5 posted about this article.
These comments are anonymously submitted by the website visitors.
TITLE AUTHOR DATE
I have known this for years David Lane Saturday, Apr. 05, 2003 at 12:57 AM
These references are further proof Paul King Saturday, Apr. 05, 2003 at 12:59 AM
hmm Scottie Saturday, Apr. 05, 2003 at 1:43 AM
OR Paul King Saturday, Apr. 05, 2003 at 1:56 AM
Paul Scottie Saturday, Apr. 05, 2003 at 5:51 PM

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