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The Invisible Cure: Africa, the West, and the Fight Against AIDS

Edward C. Green, PhD, Reviewer
JAMA. 2008;300(5):587-589. doi:10.1001/jama.300.5.587.
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Starting in the late 1990s, evidence from Uganda began to challenge AIDS prevention orthodoxy. Until then, there was seldom disagreement over how to prevent AIDS. According to the general consensus, risk-reduction measures, especially condom promotion, treating the curable sexually transmitted diseases, and voluntary counseling and testing constituted “best practices” for prevention of sexually transmitted human immunodeficiency virus (HIV) infections. Along with this has come a great deal of concern over human rights, women's rights, and antistigma advocacy that does not always turn into interventions funded with AIDS money but that nevertheless has shaped arguments about prevention and resulted in unprecedented levels of funding being directed at a single disease entity. Some have argued that the unprecedented decrease in HIV prevalence in Uganda during the 1990s was due primarily not to these established best practices but to massive and rapid behavior change resulting in a primary reduction in numbers of sex partners.1


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