Dynamics of HIV epidemics in sub-Saharan Africa: introduction.

Abstract

For many years the differing rates of HIV morbidity in various parts of Africa were attributed mainly to different timing of the introduction of the virus into the general population--as if the level of HIV should inevitably as a sort of natural evolution reach prevalences of about 30%. This is particularly true in sub-Saharan Africa where HIV spreads heterosexually in adults and shows little or no sign of decline. However a multicenter study published in this special UN Joint Progam on AIDS (UNAIDS) supplement was carried out in four African cities specifically to help understand why HIV spreads at different rates and reached different prevalences in these cities. Variations in vulnerability leading to increased HIV sexual exposure and greater efficiency of transmission [related to different patterns of sexual networking and differing prevalences of sexually transmitted diseases for example] were believed to be major epidemiological factors explaining more generalized HIV epidemics in some regions. Targeting children before they initiate sexual activity circumcising males and combating genital herpes are all suggested interventions.