Médecine communautaire et éducation à la santé

Abstrait

Combating HIV/AIDS in Selected Sub-Saharan African Countries: Progress towards Millennium Development Goal 6

Anouk P Meijs, Rob MPM Baltussen, André JAM van der Ven and Gerhard A Zielhuis

Background:UN Millennium Development Goal six (MDG6) includes HIV/AIDS as an important target. As sub-Saharan Africa (SSA) accounts for the majority of the global HIV incidence and prevalence, the aim of this study is to describe how selected countries in SSA are on track towards reaching this goal.

Methods:Twelve countries with a generalized epidemic in SSA were selected and classified into four groups with either high or low HIV prevalence, and major or minor efforts made to realize MDG6. The five official indicators of MDG6 were used to measure progress and a comparison was made between the four groups.

Results: 1) HIV prevalence has stabilized in many countries, but this seems unrelated to the amount of efforts countries have made. 2) Access to antiretroviral therapy increased most in high prevalence countries, especially in countries that put much effort in HIV programmes. 3) School attendance was high for both orphans and non-orphans in most countries, and this was seemingly unrelated to the level of efforts. 4) Knowledge about HIV was low and hardly increased over time, although levels were higher in countries with high prevalence. 5) Condom use in high-risk sexual encounters was and remained low for most low prevalence countries. In high prevalence countries large differences in condom use between countries were observed, independent of the amount of efforts.

Conclusion:Antiretroviral therapy coverage has increased considerably over time, and several countries will reach the stated objective on this indicator. However, knowledge about HIV and promotion of safe sex is still lagging behind. A further increase of access to antiretroviral therapy seems a promising strategy to combat HIV/AIDS in the near future in SSA countries. Nevertheless, effort in educating the population can reduce the incidence of HIV by changing the population’s behaviour, which remains the best long-term strategy.