Abstinence, fewer partners, condom use are complementary messages.
The first phase of a major six-country study suggests that promotion of abstinence from sex to prevent HIV infection contributed to an approximately one- year delay of sexual initiation among youth in two countries -- Uganda and Zambia-- where H1V prevalence declined throughout the 1990s. In both countries, delayed sexual initiation among youth, abstinence, and condom use with nonregular partners all contributed to declines in HIV prevalence. However, the study concluded, HIV declines were probably due primarily to both adolescents and adults having fewer sexual partners, In Thailand, a third country where HIV prevalence declined, reductions in commercial sex and other nonmarital sexual relationships and increases in condom use during commercial sex likely contributed to the decline. This type of multifaceted behavior change did not occur to the same extent in the other three countries in the study -- Cameroon, Kenya, and Zimbabwe-- where HIV prevalence did not decline, Thus, the "ABC strategy" (abstinence, be faithful to one partner or reduce number of partners, or -- if "A" or "B" cannot be achieved -- use condoms consistently and correctly) continues to be an appropriate general recommendation. And rues- sages to delay sexual initiation or to begin practicing abstinence even after having been sexually active need to be an integral part of programs to prevent HIV, other sexually transmitted infections (STIs), and pregnancy among unmarried youth. (excerpt)