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UN: AIDS Awareness Is High But Behavior Remains Risky

The United Nations this week presented the results of an HIV/AIDS survey encompassing 39 countries in Africa, Asia, and Latin America. The report concluded that awareness is increasing, but that defeating the epidemic will require dramatic changes in sexual and reproductive behavior. Although the study did not include HIV/AIDS trends in Eastern Europe and the former Soviet Union, some experts say the trends in these regions are similar and that the survey's conclusions can prove useful.

United Nations, 26 June 2002 (RFE/RL) -- A report presented on 24 June at the United Nations, entitled "HIV/AIDS: Awareness and Behavior," found that awareness of HIV/AIDS is increasing worldwide, but that sexual behavior remains risky. The survey included information from 39 countries in Africa, Asia, and Latin America.

Joseph Chamie is the director of the United Nations Population Division. He says the results of the survey are not surprising: "Generally, the findings confirmed a great deal of what one would suspect: Awareness is increasing, but behavior remains risky. We see differences between rural and urban areas. Rural areas are doing much worse than urban areas. There's also a gap between men and women. We also looked into other issues, and what is the most frequently common way to learn about HIV/AIDS. In surveys, we found out that radio was the most common way, important source of information about this."

The report says about half of the female respondents and more than seven in 10 male respondents say they heard about HIV/AIDS for the first time on the radio.

Chamie said the survey data was collected in the late 1990s and thus reflects the situation of several years ago. He said there are indications that the attitudes today may be changing.

"My impression is that it's likely to be changing. There have been some behavioral changes, especially among the men reducing the number of partners, some use of condoms, and so on. So I would probably say yes, we need more surveys and more data to look into this. But it's clear that we need enormous behavioral change in the reproductive sexual practices of men and women in order to effectively deal with the increasing consequences of the epidemic."

Chamie noted that most of the information collected came from household interviews with women. Increasingly, he says, researchers have been trying to interview men, but in many cultures, questions dealing with reproductive sexual behavior are considered very sensitive, if not taboo.

In larger, developed, countries, a significant segment of the epidemic spreads through homosexual activities and drug use, Chamie says. In the developing countries, he says, the spread of HIV/AIDS is for the most part through heterosexual activity.

Although the countries of Eastern Europe and the former Soviet Union were not included in the survey, researchers note troubling signs about the rates of infection in these regions.

Joia Mukherjee is the medical director of Partners in Health, a Boston-based NGO. She tells RFE/RL that it was a major oversight by the UN not to include the countries of the former Soviet Union and Eastern Europe in the survey.

Mukherjee is currently conducting AIDS-related research in the Siberian town of Tomsk. She says the countries of the former Soviet Union have the fastest-growing rate of HIV infection in the world. "The main risk factors in the several studies I have been done [in Russia], behavioral risk factors, is really the poverty. So even among IV [intravenous] drug users, among male and female prostitutes, the major risk factor is people who are exchanging sex for money, who are living in poverty, who had become homeless -- these seem to be the major risk factors. And that's what we see in Africa, what we see in Latin America, and we do a lot of HIV work in Haiti."

Mukherjee says that in rural Tomsk, for example, researchers are starting to see the troubling first cases of HIV and tuberculosis co-infection. She described Tomsk residents as being worried about the rapidly increasing rates of HIV infection but like many areas where the disease is spreading, somewhat surprised that it could happen to them.

"In the beginning phases of [HIV] epidemics in many countries, the United States included, people felt that, you know, it wouldn't be involving them. Because HIV [AIDS] is a disease of stigma, it is very easy to say this is going to happen to other people, bad people, different people, and not me. So I think that's been a common thread throughout the HIV [AIDS] epidemic."

Fred Eckhard, the spokesman for UN Secretary-General Kofi Annan, tells RFE/RL that during a recent trip to Russia and Ukraine, Annan met with representatives of nongovernmental organizations dealing with HIV/AIDS issues. Eckhard says Annan was impressed by their activism.

"The UN secretary-general in his recent visit to Ukraine and Russia met with NGOs that are extremely active and well-organized. So the sense is that there is a growing perception of the dimensions of the problem [of HIV/AIDS] and eagerness on the part of citizens to deal with it, perhaps a greater eagerness at that level than even at the official level."

(The full text of the UN report may be accessed on the Internet at