ABSTRACT
Effective HIV prevention requires primary behavior change, not just risk reduction measures to ameliorate the effects of risky sex and drug use. We cannot point to any randomized controlled trial (RCT) of abstinence and faithfulness interventions or any other clear study or piece of data that definitively proves that behavioral interventions are the key to HIV prevention. There is also evidence to suggest that delay of sexual debut or abstinence can reduce HIV risk at an individual level. The primary factor that explains HIV incidence and prevalence decline in Uganda is reduction in the proportion of men and women who report more than one partner in the previous year. Zimbabwe has also experienced changes in sexual behaviors, and, as in Uganda and Kenya, these changes seem to be the primary factors associated with a large decline in HIV prevalence. In Zimbabwe, as in Kenya, there were increases in abstinence, faithfulness, and condom use behaviors between 1998 and 2003.
