Aids campaign failing in Uganda

ONE of the most extensive health campaigns designed to curb the spread of the Aids virus in Africa is failing to stop significant numbers of people becoming infected, according to a scientific study published today.

In a single year at least 2 per cent of the sexually active population in Uganda, which was one of the first African countries to start a national programme on Aids education, became infected with HIV.

Scientists found that most of those who became HIV-positive knew about the risk of contracting the virus and had even attended an Aids-education rally. The researchers also found an increase in promiscuity among the volunteers in the study, despite health warnings about the risks involved.

'Knowledge of Aids is almost universal and most subjects had attended an Aids- education rally during the period of observation,' the researchers report in the British Medical Journal. 'It is therefore disturbing that the proportion of all adults admitting to multiple sexual partners in the previous year increased significantly from 8.9 per cent to 12.3 per cent between 1989 and 1990.'

Maria Wawer, an associate professor at the Columbia University School of Public Health in New York, led the international research team, which followed 1,292 adults living in a rural area of Uganda where about one in five of sexually active adults is infected.

The team tested for HIV in 1989 and then followed up with another test in 1990 on 774 people who remained in the study. Twenty-one subjects had become HIV-positive: an infection rate of just over 2 per cent.

The most significant risk factor associated with becoming HIV-positive was the number of sexual partners. Infection rates increased to 7.3 per cent for people reporting two partners and 9.7 per cent for those reporting three.

Professor Wawer and colleagues believe that the figures on the transmission rates are under-estimates, because the study failed to keep track of many young, itinerant men 'who would be expected to contribute disproportionately' to HIV infections.

The scientists believe that the transmission of HIV in this rural area of Uganda is 'almost exclusively through heterosexual exposure'.

Professor Roy Anderson of Oxford University said the 2 per cent infection rate represented an 'extraordinary rate of growth' of HIV-positive people. 'One of the most striking things is that extensive health campaigns aimed at slowing the spread have not seemingly affected this increase. It is a most depressing result and even greater efforts must be made to curb HIV transmission.'