News / Africa

HIV/AIDS Prevention Efforts Need New, Innovative Thinking


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.”


“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

Afghanistan, Pakistan Leaders to Hold Icebreaking Talks in Paris

Two sides are expected to discuss ways to ease bilateral tensions and jointly work for resumption of stalled peace talks between Afghan government and Taliban officials

Corruption Busting Is Her Game

South African activist is building 'international online community of thousands of corruption fighters'

Former SAF Businessman Gives Books, Love of Reading to Students

Steve Tsakaris now involved in nonprofit Read to Rise, which distributes books in Soweto, encourages lower-grade primary school students to read

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

By the Numbers

Featured Videos

Your JavaScript is turned off or you have an old version of Adobe's Flash Player. Get the latest Flash player.
Belgium-Germany Border Remains Porous, Even As Manhunt For Paris Attacker Continuesi
Ayesha Tanzeem
November 25, 2015 10:46 PM
One of the suspected gunmen in the Nov. 13 Paris attacks, Salah Abdeslam, evaded law enforcement, made his way to Belgium, and is now believed to have fled to Germany. VOA correspondent Ayesha Tanzeem makes the journey across the border from Belgium into Germany to see how porous the borders really are.

Video Belgium-Germany Border Remains Porous, Even As Manhunt For Paris Attacker Continues

One of the suspected gunmen in the Nov. 13 Paris attacks, Salah Abdeslam, evaded law enforcement, made his way to Belgium, and is now believed to have fled to Germany. VOA correspondent Ayesha Tanzeem makes the journey across the border from Belgium into Germany to see how porous the borders really are.

Video Islamic State Unfazed by Losses in Iraq, Syria

Progress in the U.S.-led effort to beat Islamic State on its home turf in Iraq and Syria has led some to speculate the terror group may be growing desperate. But counterterror officials say that is not the case, and warn the recent spate of terror attacks is merely part of the group’s evolution. VOA National Security correspondent Jeff Seldin has more.

Video Taiwan Looks for Role in South China Sea Dispute

The Taiwanese government is one of several that claims territory in the hotly contested South China Sea, but Taipei has long been sidelined in the dispute, overshadowed by China. Now, as the Philippines challenges Beijing’s claims in an international court at The Hague, Taipei is looking to publicly assert its claims. VOA’s Bill Ide has more from Beijing.

Video Syrian Refugees in US Express Concern for Those Left Behind

Syrian immigrants in the United States are concerned about the negative tide of public opinion and the politicians who want to block a U.S. plan to accept 10,000 Syrian refugees. Zlatica Hoke reports many Americans are fighting to dispel suspicions linking refugees to terrorists.

Video After Paris Attacks, France Steps Up Fight Against IS

The November 13 Paris attacks have drawn increased attention to Syria, where many of the suspected perpetrators are said to have received training. French President Francois Hollande is working to build a broad international coalition to defeat Islamic State in Syria and in Iraq. Zlatica Hoke reports.

Video US, Cambodian Navies Pair Up in Gulf of Thailand

The U.S. Navy has deployed one of its newest and most advanced ships to Cambodia to conduct joint training drills in the Gulf of Thailand. Riding hull-to-hull with Cambodian ships, the seamen of the USS Fort Worth are executing joint-training drills that will help build relations in Southeast Asia. David Boyle reports for VOA from Preah Sihanouk province.

Video Americans Sharpen Focus on Terrorism

Washington will be quieter than usual this week due to the Thanksgiving holiday, even as Americans across the nation register heightened concerns over possible terrorist threats. VOA’s Michael Bowman reports new polling data from ABC News and the Washington Post newspaper show an electorate increasingly focused on security issues after the deadly Islamic State attacks in Paris.

Video World Leaders Head to Paris for Climate Deal

Heads of state from nearly 80 countries are heading to Paris (November 30-December 11) to craft a global climate change agreement. The new accord will replace the Kyoto Protocol on Climate Change that expired in 2012.

Video Uncertain Future for Syrian Refugee Resettlement in Illinois

For the trickle of Syrian refugees finding new homes in the Midwest city of Chicago, the call to end resettlement in many U.S. states is adding another dimension to their long journey fleeing war. Organizations working to help them integrate say the backlash since the Paris attacks is both harming and helping their efforts to provide refugees sanctuary. VOA's Kane Farabaugh reports.

Video Creating Physical Virtual Reality With Tiny Drones

As many computer gamers know, virtual reality is a three-dimensional picture, projected inside special googles. It can fool your brain into thinking the computer world is the real world. But If you try to touch it, it’s not there. Now Canadian researchers say it may be possible to create a physical virtual reality using tiny drones. VOA’s George Putic reports.

Video New American Indian Village Takes Visitors Back in Time

There is precious little opportunity to experience what life was like in the United States before its colonization by European settlers. Now, an American Indian village built in a park outside Washington is taking visitors back in time to experience the way of life of America's indigenous people. Carol Pearson narrates this report from VOA's June Soh.

Video Even With Hometown Liberated, Yazidi Refugees Fear Return

While the northern Iraqi town of Sinjar has been liberated from Islamic State forces, it's not clear whether Yazidi residents who fled the militants will now return home. VOA’s Mahmut Bozarslan talked with Yazidis, a religious and ethnic minority, at a Turkish refugee camp in Diyarbakır. Robert Raffaele narrates his report.

Video Nairobi Tailors Make Pope Francis’ Vestments

To ensure the pope is properly attired during his visit, the Kenya Conference of Catholic Bishops asked the Dolly Craft Sewing Project in the Nairobi slum of Kangemi to make the pope's vestments, the garments he will wear during the various ceremonies. Jill Craig reports.

Video Cross-Border Terrorism Puts Europe’s Passport-Free Travel in Doubt

The fallout from the Islamic State terror attacks in Paris has put the future of Europe’s passport-free travel area, known as the "Schengen Zone," in doubt. Several of the perpetrators were known to intelligence agencies, but were not intercepted. Henry Ridgwell reports from London European ministers are to hold an emergency meeting Friday in Brussels to look at ways of improving security.

Video El Niño Brings Unexpected Fish From Mexico to California

Fish in an unexpected spectrum of sizes, shapes and colors are moving north, through El Niño's warm currents from Mexican waters to the Pacific Ocean off California’s coast. El Nino is the periodic warming of the eastern and central Pacific Ocean. As Faiza Elmasry tells us, this phenomenon thrills scientists and gives anglers the chance of a once-in-a-lifetime big catch. Faith Lapidus narrates.

Video Terrorism in Many Forms Continues to Plague Africa

While the world's attention is on Paris in the wake of Friday night's deadly attacks, terrorism from various sides remains a looming threat in many African countries. Nigerian cities have been targeted this week by attacks many believe were staged by the violent Islamist group Boko Haram. In addition, residents in many regions are forced to flee their homes as they are terrorized by armed militias. Zlatica Hoke reports.

Video Study: Underage Marriage Rate Higher for Females in Pakistan

While attitudes about the societal role of females in Pakistan are evolving, research by child advocacy group Plan International suggests that underage marriage of girls remains a particularly big issue in the country. VOA’s Ayesha Tanzeem reports how such marriages leads to further social problems.

VOA Blogs