AIDS and Behavior

, Volume 10, Issue 4, pp 335-346

First online:

Open Access This content is freely available online to anyone, anywhere at any time.

Uganda's HIV Prevention Success: The Role of Sexual Behavior Change and the National Response

  • Edward C. GreenAffiliated withHarvard University School of Public Health
  • , Daniel T. HalperinAffiliated withAIDS Research Institute, University of CaliforniaNERCHA, Mbabane Email author 
  • , Vinand NantulyaAffiliated withGlobal Fund for AIDS, Tuberculosis and Malaria
  • , Janice A. HogleAffiliated withFamily Health International

There has been considerable interest in understanding what may have led to Uganda's dramatic decline in HIV prevalence, one of the world's earliest and most compelling AIDS prevention successes. Survey and other data suggest that a decline in multi-partner sexual behavior is the behavioral change most likely associated with HIV decline. It appears that behavior change programs, particularly involving extensive promotion of “zero grazing” (faithfulness and partner reduction), largely developed by the Ugandan government and local NGOs including faith-based, women’s, people-living-with-AIDS and other community-based groups, contributed to the early declines in casual/multiple sexual partnerships and HIV incidence and, along with other factors including condom use, to the subsequent sharp decline in HIV prevalence. Yet the debate over “what happened in Uganda” continues, often involving divisive abstinence-versus-condoms rhetoric, which appears more related to the culture wars in the USA than to African social reality.


HIV-AIDS prevention Africa behavior change ABC partner reduction multi-sectoral response.