Last week I mentioned that the number of centenarians is predicted to increase to over one million in five different countries by
2100.  
I thought that this was, in part at least, a testimony to better medical practices and aged care
in many parts of the world. 

Along similar lines, in terms of speaking of better medical practice – an interesting study was published earlier this year discussing the
marked decline in HIV prevalence in Zimbabwe. In 1997, the estimated adult
prevalence of HIV was 29% per cent of the population. Only a decade later, in
2007, this prevalence had almost been halved – to 16% estimated adult
prevalence.  The study, entitled “A
Surprising Prevention Success: Why Did the HIV Epidemic Decline in Zimbabwe?”, concluded that it was behavioural changes – specifically reductions in
extramarital, commercial, and casual sexual relations, and associated
reductions in partner concurrency – that were crucial. These behavioural
changes were influenced and helped by a couple of things:

• the increased awareness of AIDS deaths (that is, people
  coming face to face with the terrible consequences of the disease in their
  friends and families); and
  

• Zimbabwe’s economic deterioration – less disposal income
  means less money to spend on prostitutes or on multiple, concurrant sexual relationships.
  

While the report acknowledged that condom use has its place
in preventing HIV, it also stated that similarly high levels of condom use in
other African countries had not led to substantial declines in HIV
prevalence.  Therefore, condoms by
themselves are not the silver bullet. Instead, Zimbabweans had to change –
risky sexual behaviour had to stop.  For
a Zimbabwean perspective on the report, see this fascinating article from the
ZimDaily, which draws attention to the change in morality (and not just doing the same thing with condoms and expecting a different result) that is required to combat HIV.
These findings are also in line with those of Edward Green, whose views in his latest
book are excellently summarised by Dale O’Leary on the mainpage of Mercatornet.

This report on Zimbabwe does not fit into the ideological view that
condoms are the only answer and that people’s behaviour cannot be, and should
not be changed (after all, that would not be tolerant of us, we would be
terribly judgmental if we were to suggest that people change their sexual
practices!) Therefore, it is perhaps no surprise that it has not been given
much airtime in media outlets. Indeed before reading this today, I had no idea
that Zimbabwe’s incidence of HIV was in decline, let alone why that was!

Hopefully the report’s findings will be listened to and
acted upon by the various governments and NGOs involved in combating the spread
of HIV. Perhaps in the future we will look back on the successful conclusion to
that fight as another milestone in medicine. Hopefully.