Despite efforts, AIDS continues it’s march through Africa

A comprehensive article in the Washington Post. The problem is multiple sex partners…

Spread of AIDS in Africa Is Outpacing Treatment – washingtonpost.com

"At the moment, I just see a never-ending sea of disaster," said Venter, 37, the dark-haired, long-limbed president of the Southern African HIV Clinicians Society.

Underlying his frustration are grim statistics: For every South African who started taking antiretroviral drugs last year, five others contracted HIV, the same ratio as on the continent as a whole, U.N. reports say. A South African turning 15 today has a nearly 50 percent chance of contracting the virus in his or her lifetime, research shows.

The problem is not the medicine, which is among the most powerful in the world. In places such as the United States and Europe, where prevention programs were already succeeding against much smaller epidemics, the arrival of antiretroviral drugs was a turning point in the battle against AIDS.

But in sub-Saharan Africa, prevention programs have mostly failed to curb the behavior — especially the habit of maintaining several sexual partners at a time — that drives the epidemic, research indicates.

So while antiretroviral drugs have prolonged and improved the lives of hundreds of thousands of Africans, millions more are being newly infected with a disease that is still incurable and, for most, terminal.

In South Africa, AIDS deaths are projected to increase at least through 2025 despite steadily improving access to antiretrovirals, according to the Actuarial Society of South Africa. The prognosis on the rest of the continent is at least as bleak.

Global health officials and AIDS activists once predicted that expanding treatment would bolster prevention efforts by encouraging more openness about the disease and making it easier to educate people on how to protect themselves from HIV.

>>>>>>>>>>>>>>>>>>

National prevention programs, which have emphasized condom use and HIV testing but rarely featured frank discussions of the dangers of multiple sex partners, have done no better, Venter said. Health officials have also shown little enthusiasm for expanding access to circumcision, despite research showing that it can dramatically slow the pace of new infections.

"South Africa has had huge money poured into it for prevention and done diddly squat," he said.

Moloi had her own frustrations. The roster of orphans whose care she oversaw continued to grow — it numbers 450 now — in an indication that AIDS deaths were not slowing. And as orphans reached their mid-teens, Moloi saw them adopting the same sexual behaviors that had led many of their parents to contract HIV.

Boys generally kept several girlfriends, and girls often had two or more boyfriends, she said. They used condoms inconsistently, if at all.

"People are not abstaining. People are not using condoms," Moloi said. "People say it’s boring."

She recalled spotting the swollen belly on a petite 16-year-old orphan who only two years earlier had lost her own mother, probably to AIDS. During a visit to the girl’s home, Moloi administered a pregnancy test. It was positive. She learned from a neighbor that the girl had two boyfriends.

Moloi urged her to take an HIV test. She refused.

"They are breaking my heart," Moloi said. "I see AIDS. I’m not seeing life."