Investigating trends in HIV transmission and risk factors in Zambia

Higher socioeconomic status was associated with
having more sexual partners before the HIV epidemic
in Africa, and early surveys showed higher levels of
HIV prevalence among wealthy and educated people.
This book examines trends in HIV prevalence and
risky sexual behaviours in Zambia since the mid
1990s. Population-based data reveal a shift towards
safer sexual behaviour with a decrease in the
proportion reporting multiple or concurrent partners
and an increase in condom use with casual partners.
The changes are clearest among young urban people
with more than secondary education. The same group
also appears with the most marked decline in HIV
prevalence, both in population-based surveys and in
surveillance using pregnant women. These consistent
trends are likely to be signs of real behaviour
changes that have contributed to a decline in
incidence of HIV infection. However, data from
antenatal clinics indicate that there are diverging
trends in different geographical areas. This could
be a sign of differences in the effectiveness of HIV
prevention, and highlights the critical importance
of further strengthening HIV prevention.

Autorentext
Ingvild Fossgard Sandøy is a medical doctor. In 2008 she defended her PhD thesis at the University of Bergen (UoB), Norway. Her research was part of a research collaboration between the Centre for International Health at UoB and the University of Zambia. She is currently working as a researcher at the Centre for International Health.

Klappentext
Higher socioeconomic status was associated with having more sexual partners before the HIV epidemic in Africa, and early surveys showed higher levels of HIV prevalence among wealthy and educated people. This book examines trends in HIV prevalence and risky sexual behaviours in Zambia since the mid 1990s. Population-based data reveal a shift towards safer sexual behaviour with a decrease in the proportion reporting multiple or concurrent partners and an increase in condom use with casual partners. The changes are clearest among young urban people with more than secondary education. The same group also appears with the most marked decline in HIV prevalence, both in population-based surveys and in surveillance using pregnant women. These consistent trends are likely to be signs of real behaviour changes that have contributed to a decline in incidence of HIV infection. However, data from antenatal clinics indicate that there are diverging trends in different geographical areas. This could be a sign of differences in the effectiveness of HIV prevention, and highlights the critical importance of further strengthening HIV prevention.