Marseille 2007
Marseille 2007
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Abstract #691  -  Causes of HIV Prevalence Decline in Zimbabwe: Natural Dynamics versus Behaviour Change
Session:
  27.6: Plenary (Plenary) on Tuesday @ 08.30-10.30 in HC, Auditorium/Overflow Chaired by Frans van den Boom, Susan Kippax, Benjamin Coriat
Authors:
  Presenting Author:   Dr Simon Gregson - Imperial College London, United Kingdom
 
  Additional Authors:   
Aim:
Background HIV prevalence is static or continues to rise in many countries in sub-Saharan Africa but a recent epidemiological review provided convincing evidence for a decline in Zimbabwe. The causes of this decline need to be understood so that appropriate interventions can be applied locally and elsewhere.
 
Method / Issue:
Statistical and mathematical modelling analyses of longitudinal data from a general population cohort on trends in HIV prevalence, mortality, HIV incidence and sexual behaviour collected between 1998 and 2005 in Manicaland, eastern Zimbabwe.
 
Results / Comments:
Provisional results indicate that HIV prevalence in adult males and females, respectively, declined from 26% and 19% in 1998-2000 to 22% and 18% in 2001-2003 and 20% and 16% in 2003-2005. Mortality rose between the two inter-survey periods whilst HIV incidence fell from 1.7% to 1.0%. Median age at first sex increased from 18.3 years to 19.5 years in males and 18.5 years to 18.9 years in females. There was also evidence for reductions in rates of sexual partner change and for fairly high and increasing levels of consistent condom use in casual partnerships. Selective mortality and greater mobility amongst individuals with the high-risk behaviour are unlikely to fully account for these trends.
 
Discussion:
Conclusion Conscious behaviour change has contributed to the decline in HIV prevalence in eastern Zimbabwe. Similar changes have been observed at the national level and investigations are currently ongoing into the likely contributions of intervention programmes as opposed to spontaneous behaviour change triggered by high mortality - to these changes.
 
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