Zimbabwe and Uganda changes in HIV/AIDS prevalence are NOT analogous!

Kesaobaka Modukanele

Response to HIV Decline Associated with Behavior Change in Eastern Zimbabwe article

Blog post for Tuesday October 20^th, 2009

The article HIV Decline Associated with Behavior Change in Eastern Zimbabwe delves into the main reasons for HIV prevalence decline in Zimbabwe. Among other factors like AIDS mortality, and reduced fertility in HIV positive women, the study “report[ed] a decline in HIV prevalence in eastern Zimbabwe between 1998 and 2003 associated with sexual behavior change in four distinct socioeconomic strata. (2)” Furthermore, this decline in prevalence rate was observed in more educated groups. The study then mentions briefly that despite the fact that high numbers of young adults migrated in pursuit of employment, there were “no differences in HIV prevalence or sexual risk behavior between migrants and residents at baseline”. It amazes me that the study immediately compares Zimbabwe’s case to that of Uganda – attributing all of the changes in HIV/AIDS prevalence to an overall change in risky sexual behavior. I do think there are variables that are not being taken into consideration. During the time of this study, Zimbabwe was going through intense political turmoil. My inclination was that any decline in HIV/AIDS prevalence rate would be because of the heavy migration patterns in Zimbabwe. According to an article I read in The Zimbabwe Independent, Zimbabwe’s leading business weekly newspaper, as of 2006, and population in Zimbabwe declined by 4 Million people! This decline is definitely not due to immediate migration but rather, many Zimbabwean residents had gradually left the country, fleeing harsh political and socio-economic condition, to neighboring countries like Botswana and South Africa. Therefore, my impression was that this study, although it did observe changes in sexual behavior patterns among the middle aged Zimbabwean population, did not do enough investigation on other factors that might have actually led to the decline in prevalence rate. In other words, the study convinces me that sexual behavior patterns in Zimbabwe did change between 1998 and 2003, but it does not sufficiently convince me that the decline in HIV prevalence rate was predominantly due to this change in behavior. To me, this article vaguely touches on other factors that may have contributed, such as migration patterns in Zimbabwe.