Abstract

Information on the transmission of the human immunodeficiency virus (HIV), leading to acquired immunodeficiency syndrome (AIDS), has been widely disseminated since the early 1980s, and yet curbing new infections remains a major public health dilemma. In response to the global challenge of HIV/AIDS, most control and prevention interventions have targeted "core groups' with messages which include:- 1. Reduction of individual risk through responsible sexual behaviour or behaviour change, such as, delayed sexual debut, abstinence, monogamy and condom use. 2. Communal (as a society) adoption of a risk reduction strategy e.g. reduced rate of sexual partner change and avoiding multiple partners. 3. Improved, early and aggressive STD treatment programmes. However, data from sub-Saharan Africa and elsewhere shows how the epidemic, in the general population, appears to thrive unabatted. Large proportions of women and some men, in none of the traditional high risk core groups, are increasingly becoming infected with HIV. Most of the women appear to be at risk of infection not so much because of their own behaviour, but that of their partners of husbands. In this continuum, our response has been fragmented and non-strategic. Few programme activities have been developed that address men as a critical core group potentially propagating or sustaining the epidemic. The preoccupation with female sex workers and other core groups (e.g. truck drivers) could have overshadowed the need for programmes and interventions that make men, in general, aware of HIV risk and less likely to infect their sexual partners. Challenges posed by HIV require innovative strategies that foster behavioural and social change in the situation of men at risk and their partners.

PIP:

Checking the spread of HIV infection remains a public health challenge. Most HIV/AIDS control and prevention interventions have targeted core groups thought to be at high risk of infection, such as female prostitutes and truck drivers. Data from sub-Saharan Africa and elsewhere, however, indicate that despite the implementation of targeted prevention and control interventions, HIV infection continues to spread without challenge. Large proportions of women and some men in no traditional high risk core group are increasingly becoming infected with HIV. Most of the women seem to be at risk of infection as a result of their partners' or husbands' risk behavior. The preoccupation with targeting female prostitutes and other core groups has meant that the need to focus upon men overall as a risk group has been largely ignored. Only few program activities have been developed to make the broad male population aware of HIV risk and less likely to infect their sex partners.