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Unformatted text preview: Print http://www.slate.com/toolbar.aspx?action=print&id=2166210 1 of 3 12/8/2008 10:28 PM MEDICAL EXAMINER Sex Nets The puzzling rise and fall and rise of HIV and AIDS in Africa. By Jon Cohen Posted Tuesday, May 15, 2007, at 3:00 PM ET In 10 countries in sub-Saharan Africa, HIV has infected 10 percent or more of adults. No other region of the world has a country with a prevalence rate in the double digits; in North America and Europe, HIV infection has never even reached 1 percent—anywhere. To tease out the reasons for the difference, epidemiologists have journeyed deep into one of sub-Saharan Africa's thickest and dankest jungles: human sexual behavior. AIDS researchers over the past two decades have dissected when Africans start having sex, how many partners they have, how frequently they do it, their marital status and condom use, whether sex involves the exchange of money or a gift, the ability to refuse, exotic ritual practices, and orifice preferences. Uganda has received particularly close scrutiny, and is at the hub of Helen Epstein's new book, The Invisible Cure: AIDS in Africa . As Epstein recounts, Uganda had one of the world's most intense AIDS epidemics, peaking in 1991 at an adult prevalence rate of 15 percent, though this has since dropped by more than half. Many trees have died for documents that conclude that " we may never fully know " what accounts for this "miracle" and why it has happened in only a few other countries. Epstein sides with the camp that attributes Uganda's HIV/AIDS drop to behavior change. This was catalyzed by an "extraordinarily pragmatic and candid" response to the epidemic at all levels of society—in contrast to many other devastated countries, where health officials misunderstood how HIV was spreading. The main driver of severe HIV/AIDS epidemics is the distinct way that populations form sexual networks, Epstein argues. And on this topic, she hits many high notes. Ultimately, however, Invisible Cure makes a more convincing case for the cause of double-digit HIV/AIDS epidemics than for their cure. Epstein, a lapsed laboratory scientist who did graduate work in public health, is a plucky and enterprising character. She abandoned her molecular studies of insects for a self-designed (though ill-fated) AIDS vaccine research project in Uganda and then visited half a dozen sub-Saharan countries over the next decade as a consultant for the Ford Foundation and Human Rights Watch and as a journalist. Her time in Africa convinced her that home-grown social movements powerfullyand as a journalist....
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- Spring '10
- Health Psychology, Epstein, Sexual intercourse, Helen Epstein