, Volume 10, Issue 4, pp 347-350,
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Date: 25 Apr 2006

Uganda’s HIV Prevention Success: The Role of Sexual Behavior Change and the National Response. Commentary on Green et al. (2006)

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The paper by Green et al. (vol. 10, this issue, AIDS and Behavior). on “Uganda’s HIV Prevention Publisher: Please provide article acceptance information. Success” concludes that “a decline in multipartner sexual behavior” is the most likely explanation for the declines in HIV prevalence. However, this article neither addresses the inconsistencies in the available behavioral data, nor considers epidemiologic factors that may affect HIV prevalence. The latter include the fact that prevalence is a product of incidence and duration of infection (i.e., time from infection to death), and incidence is affected by infectivity per coital act that varies with the stage of disease, the number of sexual contacts, and the duration of exposures (i.e., sexual relationships). We thus consider additional factors which may have affected the history of HIV in Uganda and discuss data quality and consistency as well as epidemiologic issues.

Prior to 1989 there are no reliable population-based data on HIV or