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Document Abstract
Published: 2003

A, B and C in Uganda: the roles of abstinence, monogamy and condom use in HIV decline

What are the causes of Uganda's decline in HIV prevalence rates?
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Policymakers around the world look to Uganda as a role model in the fight against HIV/AIDS, because of its success in reducing HIV rates. This study attempts to understand the Ugandan experience by analysing the policies adopted in the country and their consequences.

Since the late 1980s, the Ugandan government, NGOs and activists have promoted a comprehensive approach to prevention, termed “ABC” (Abstinence, Be Faithful (monogamy) and Use Condoms). Findings about the impact of each of these components include:

  • Abstinence:
    • the proportion of women 15–17 who had ever had sex decreased from 50% in 1988 to 46% in 1995 and 34% in 2000
    • there were also large declines in sexual experience among adolescent men between 1989–1995
    • however, abstinence did not increase among those who had already had sex
  • Monogamy:
    • men and women of all ages were much less likely to have more than one sexual partner in a 12-month period in 1995 than in 1989
    • among unmarried sexually active women, 15% had more than one partner in 1995, compared with 31% in 1989; for unmarried men, the proportions were 26% in 1995 and 59% in 1989
    • the proportions continued to decline among unmarried women between 1995–2000, but some age-groups of unmarried men were more likely to have multiple partners in 2000 than in 1995
  • Use of condoms:
    • condom use rose substantially during the 1990s among both men and women, especially those who were unmarried
    • among unmarried women who had had sex in the past four weeks, the proportion who used condoms rose from 1% in 1989 to 14% in 1995
    • among unmarried men in this category, use rose from 2% to 22%

The paper concludes that progress on the three components of the ABC approach contributed to bringing about and sustaining reduced exposure to HIV in Uganda. These results are consistent with current prevention efforts and highlight the importance of an integrated approach to combating the HIV epidemic worldwide. Development funds to combat HIV should focus on policies and programs designed to target all three prongs, although the precise contribution of each of these strategies to behaviour change in Uganda remains unknown.

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Authors

S. Singh; J.E. Darroch; A. Bankole

Focus Countries

Geographic focus

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