HIV/AIDS Stigma in Southern Africa ‘Exacerbated’ by ‘Misunderstanding’ About How HIV Spreads in the Region, Opinion Piece Says

The "profound" stigma surrounding HIV/AIDS in Southern Africa might have been "exacerbated" by a "misunderstanding of the epidemiology of HIV," Helen Epstein -- author of "The Invisible Cure: Africa, the West and the Fight Against AIDS," which is scheduled to be published in May -- writes in a Los Angeles Times opinion piece. Although Southern Africans "do not seem to have more sexual partners over a lifetime than people in the U.S.," they are more likely to have more than one long-term sexual partner that might "overlap for months or years," according to Epstein. The practice of having one sexual partner at a time "traps the virus in a relationship for months or years at a time" and "considerably slows" the progress of HIV through the population, while the "practice of formal or informal polygamy links sexually active people not only to one another but also to the partners of their partners ... creating a giant web that can extend across huge regions," Epstein writes. According to Epstein, the issue has been "absent" from school-based HIV/AIDS education curriculums and "until recently," from national strategic plans to address the virus and in media and billboard campaigns. Abstinence-based education programs and condom promotion programs, which are the main sources for information on HIV/AIDS in Southern Africa, might have "reinforced the idea that victims of the disease are those who are promiscuous rather than ordinary people in relatively ordinary relationships," Epstein writes. Promoting condom use is "important," but condoms alone won't stem the epidemic because they are "seldom used in long-term relationships," Epstein writes, adding that public health agencies in the region "must do more to inform Southern Africans about the dangers" of concurrent relationships (Epstein, Los Angeles Times, 4/15).