News / Africa

HIV/AIDS Prevention Efforts Need New, Innovative Thinking

Multimedia

Audio
Joe DeCapua

A leading researcher on the economic and development effects of HIV/AIDS says new and innovative prevention methods are needed.

South African Professor Alan Whiteside is calling for fresh ideas on breaking the HIV infection cycle by interrupting or delaying risky behavior.

“I think it would be fair to say that prevention is the orphan of the HIV response.  We’ve made huge progress with treatment,” he says, “but we haven’t stopped people getting infected.”

Whiteside is executive director of HEARD, the Health Economics and HIV/AIDS Research Division at the University of KwaZulu-Natal in Durban.  He’s also co-author of AIDS in the 21st Century.  Whiteside and Justin Parkhurst of the London School of hygiene and Tropical Medicine presented their ideas in a recent article in the Southern African Journal of HIV Medicine.

Have prevention efforts failed?

“We can never prove a negative and that’s what’s extremely frustrating.  For example, is it possible that if we hadn’t had the prevention, that levels of prevalence would be 60 or 70 percent in Swaziland instead of the 42 percent among the antenatal clinic attenders that there are,” he says.

Whiteside says prevention probably has worked, “just not well enough, particularly in the hyper-endemic countries of southern Africa.”

Out of the box

“We’re calling for innovative thinking.  The time has come for stepping out of the box and doing some new things and trying some new ideas,” says Whiteside.

Those new ideas include having a period, perhaps one month, when people make a concerted effort to practice safe sex.

“If you could have a nationwide campaign of either safe sex or no sex – and that means everybody – then you would effectively cut HIV transmission and it would give you breathing space.  And we called for perhaps a one month period of safe sex/no sex,” he says.

No sex?

Some have interpreted this to mean Whiteside and Parkhurst are calling for a month of abstinence only.

“I would say they haven’t read the article properly,” he says, adding, “What we believe would work is that if every act of sexual intercourse [were] protected, then there would be no HIV transmission during the period of a month.  And that means people who have just been infected, who have a very high viral (HIV) load, would not be transmitting during that high period of viral load.”

In time, their viral load would fall and “there would be less likelihood of them transmitting beyond that period.”

While this could be done, he says, through abstinence, it could also be achieved through condoms.

“If everybody – married or in a relationship – uses a condom, then you would have the same effect of interrupting HIV transmission.  It’s like if you took everybody who had a cold and put them in quarantine for a month.  We’re not suggesting for a moment that that’s what you do.  But we are suggesting you quarantine against HIV transmission,” he says.

Clues may be found in some Muslim countries, which often have very low HIV prevalence rates.  For example, could Ramadan practices of abstinence affect HIV transmission?  Further research would be needed.

The Whiteside/Parkhurst article says, “While Islam permits polygamy, it prohibits sex outside marriage and discourages the consumption of alcohol and homosexual sex.  All these factors may help explain the lower levels of seroprevalence in countries with large Muslim populations.”

Naysayers

“I think the really important thing to stress is this is a bold idea and we’re going to be hit by a lot of people who don’t like what we’re saying.  All we ask is think about it,” he says.

Whiteside thinks critics will accuse them of “moralizing…calling for the impossible.  And we’ll be seen as loopy academics.”

During the Bush administration, there were many calls for abstinence as part of HIV/AIDS prevention.  Abstinence was once a big part of PEPFAR, the President’s Emergency Plan for AIDS Relief.  But Whiteside says their idea is different.

“We’re not talking about the Bush type abstinence, which was abstinence until you were married and then a monogamous relationship, be faithful to one partner.  What we’re saying s that we would like a period of safe sex or if you can’t do safe sex (then) no sex.  Where you have it on a national basis or a population basis for a month,” he says.

World Cup inspiration

Behavior change has always been a difficult program to implement in HIV/AIDS prevention.

“I think the answer is that in some of the worst affected countries it is a very saleable proposition because we don’t have many choices left,” he says.

Whiteside adds, “Two months ago, I would have felt that we were dancing on the edge of insanity in this proposal.  But I’m living in South Africa and I’ve seen how our society has mobilized around the World Cup.  And I know it is possible to mobilize an entire society.  So I think it is possible to mobilize people around something as life and death as HIV transmission.”

He says the first step is simply to get people to talk about the idea.  Whiteside will try to do that when he attends the 18th International AIDS Conference in Vienna later this month.

You May Like

Scotland Vote Raises Questions of International Law

Experts say self-determination, as defined and protected by international law, confined narrowly to independence movements in process of de-colonization More

Video Whaling Summit Votes to Uphold Ban on Japan Whale Hunt

Conservationists hail ruling as a victory, but Tokyo says it will submit revised plans for a whale hunt in 2015 More

Annual Military Exercise Takes on New Meaning for Ukraine Troops

Troops from 15 nations participating in annual event, 'Rapid Trident' in western Ukraine More

This forum has been closed.
Comments
     
There are no comments in this forum. Be first and add one

Featured Videos

Your JavaScript is turned off or you have an old version of Adobe's Flash Player. Get the latest Flash player.
Russian Economy Reeling After New Western Sanctionsi
X
September 18, 2014 2:28 AM
A new wave of Western sanctions is hitting Russia’s economy hard. State-owned energy firms continue to bleed profits and Russia’s national currency plunged to a new low this week after the U.S. and the European Union announced new sanctions to punish Russia's aggressive stance in eastern Ukraine. But as Mil Arcega reports, the sanctions could also prove costly for European and American companies.
Video

Video Russian Economy Reeling After New Western Sanctions

A new wave of Western sanctions is hitting Russia’s economy hard. State-owned energy firms continue to bleed profits and Russia’s national currency plunged to a new low this week after the U.S. and the European Union announced new sanctions to punish Russia's aggressive stance in eastern Ukraine. But as Mil Arcega reports, the sanctions could also prove costly for European and American companies.
Video

Video Belgian Researchers Discover Way to Block Cancer Metastasis

Cancer remains one of the deadliest diseases, despite many new methods to combat it. Modern medicine has treatments to prevent the growth of primary tumor cells. But most cancer deaths are caused by metastasis, the stage when primary tumor cells change and move to other parts of the body. A team of Belgian scientists says it has found a way to prevent that process. Zlatica Hoke has more.
Video

Video Mogadishu's Flood of Foreign Workers Leaves Somalis Out of Work

Unemployment and conflict has forced many young Somalians out of the country in search of a better life. But a newfound stability in the once-lawless nation has created hope — and jobs — which, some say, are too often being filled by foreigners. Abdulaziz Billow reports from Mogadishu.
Video

Video A Dinosaur Fit for Land and Water

Residents and tourists in Washington D.C. can now examine a life-size replica of an unusual dinosaur that lived almost a hundred million years ago in northern Africa. Scientists say studying the behemoth named Spinosaurus helps them better understand how some prehistoric animals adapted to life on land and in water. The Spinosaurus replica is on display at the National Geographic museum. VOA’s George Putic has more.
Video

Video Iraqi Kurdistan Church Helps Christian Children Cope find shelter in churches in the Kurdish capital, Irbil

In the past six weeks, tens of thousands of Iraqi Christians have been forced to flee their homes by Islamic State militants and find shelter in churches in the Kurdish capital, Irbil. Despite U.S. airstrikes in the region, the prospect of people returning home is still very low and concerns are starting to grow over the impact this is having on the displaced youth. Sebastian Meyer reports from Irbil on how one church is coping.
Video

Video NASA Picks Boeing, SpaceX to Carry Astronauts Into Space

The U.S. space agency, NASA, has chosen Boeing and SpaceX companies to build the next generation of spacecraft that will carry U.S. astronauts to the International Space Station by the year 2017. The deal with private industry enables NASA to end its dependence on Russia to send space crews into low Earth orbit and back. Zlatica Hoke has more.
Video

Video Future of Ukrainian Former President's Estate Uncertain

More than six months after Ukraine's former President Viktor Yanukovych fled revolution to Russia, authorities have yet to gain control of his palatial estate. Protesters occupy the grounds and opened it to tourists but they are also refusing to turn it over to the state. VOA's Daniel Schearf reports from Mezhigirya, just north of Kyiv.
Video

Video China Muslims Work to Change Perceptions After Knife Attacks

China says its has sentenced three men to death and one woman to life in prison for a deadly knife attack in March that left more than 30 dead and 140 injured. Beijing says Muslim militants from China's restive western region of Xinjiang carried out the attacks. Now, more than six months after the incident, residents in the city are still coping with the aftermath. VOA's Bill Ide has more from Kunming.


Carnage and mayhem are part of daily life in northern Nigeria, the result of a terror campaign by the Islamist group Boko Haram. Fears are growing that Nigeria’s government may not know how to counter it, and may be making things worse. More

AppleAndroid