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

Turkey's Controversial Reform Bill Giving Investors Jitters

Homeland security reform bill will give police new powers in search, seizure, detention and arrests, while restricting the rights of suspects, their attorneys More

Audio Slideshow In Kenyan Prison, Good Grades Are Path to Freedom

Some inmates who get high marks could see their sentences commuted to non-custodial status More

'Rumble in the Jungle' Turns 40

'The Champ' knocked Foreman out to regain crown he had lost 7 years earlier when US government accused him of draft-dodging and boxing officials revoked his license 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.
Victorious Secularists Face Challenge to Form Government in Tunisiai
X
Henry Ridgwell
October 30, 2014 11:39 PM
Official results from Tunisia show the Islamist Ennahda party has failed to win the second free election since the so-called "Arab Spring" uprising in 2011. Ennahda, which handed power to a government of technocrats pending the elections, lost out to the secular party Nidaa Tounes. Henry Ridgwell reports from London that the relatively peaceful poll offers some hope in a volatile region.
Video

Video Victorious Secularists Face Challenge to Form Government in Tunisia

Official results from Tunisia show the Islamist Ennahda party has failed to win the second free election since the so-called "Arab Spring" uprising in 2011. Ennahda, which handed power to a government of technocrats pending the elections, lost out to the secular party Nidaa Tounes. Henry Ridgwell reports from London that the relatively peaceful poll offers some hope in a volatile region.
Video

Video Africa Tells its Story Through Fashion

In Africa, Fashion Week is a riot of colors, shapes, patterns and fabrics - against the backdrop of its ongoing struggle between nature and its fast-growing urban edge. How do these ideas translate into needle and thread? VOA’s Anita Powell visited this year’s Mercedes Benz Fashion Week Africa in Johannesburg to find out.
Video

Video Smugglers Offer Cheap Passage From Turkey to Syria

Smugglers in Turkey offer a relatively cheap passage across the border into Syria. Ankara has stepped up efforts to stem the flow of foreign fighters who want to join Islamic State militants fighting for control of the Syrian border city of Kobani. But porous borders and border guards who can be bribed make illegal border crossings quite easy. Zlatica Hoke has more.
Video

Video China Political Meeting Seeks to Improve Rule of Law

China’s communist leaders will host a top level political meeting this week, called the Fourth Plenum, and for the first time in the party’s history, rule of law will be a key item on the agenda. Analysts and Chinese media reports say the meetings could see the approval of long-awaited measures aimed at giving courts more independence and include steps to enhance an already aggressive and high-reaching anti-corruption drive. VOA’s Bill Ide has more from Beijing.
Video

Video After Decades of Pressure, Luxembourg Drops Bank Secrecy Rules

European Union finance ministers have reached a breakthrough agreement that will make it more difficult for tax cheats to hide their money. The new legislation, which had been blocked for years by countries with a reputation as tax havens, was approved last week after Luxembourg and Austria agreed to lift their vetoes. But as Mil Arcega reports, it doesn’t mean tax cheats have run out of places to keep their money hidden.
Video

Video Kobani Refugees Welcome, Turkey Criticizes, US Airdrop

Residents of Kobani in northern Syria have welcomed the airdrop of weapons, ammunition and medicine to Kurdish militia who are resisting the seizure of their city by Islamic State militants. The Turkish government, however, has criticized the operation. VOA’s Scott Bobb reports from southeastern Turkey, across the border from Kobani.

All About America

AppleAndroid