STD Prevention: Behavior Change

Safer Sex - Problems of Safer Sex Promotion

Cultural Problems - National
The first responsibility for controlling epidemics usually lies with the respective national govemments. The two following examples may be instructive: Not long ago, the HIV/AIDS infection rates in Uganda and Thailand were among the highest in the world. However, appropriate national campaigns were able to bring them down.

Uganda has been using a prevention program under the simple slogan “ABC”:

Abstinence, Being faithful, or, if the first two are not practiced, Condom use.

This program has had measurable success as the incidence of HIV infections has clearly decreased. It remains to be seen if the trend continues and how much each of the three elements contributes to the success. As long as a sufficiently large majority sticks to A and B while those at high risk adopt C, the program may indeed keep working in Uganda.

In contrast, Thailand has successfully taken another route. Realizing that most of its HIV infections could be traced to commercial sex contacts, the country started a massive campaign enforcing the use of condoms in its large sex industry:

The goal was to make condom use universal among commercial sex workers. If a client refused to cooperate, he was not to be serviced. Brothels that did not enforce this rule were closed. In addition, the government distributed large quantities of free condoms. As a result, the STD infection rate among sex worlers decreased dramatically, more men than ever now use condoms, and the spread of HIV/AIDS has significantly slowed down.
These two different approaches are not necessarily successful in other countries, but they teach the same lesson: Before any program of behavior change is launched anywhere, it is necessary to study the local culture and to devise a strategy appropriate to it. The program will then simply use “anything that gets results” in that particular locality because, in the end, only the results justify the effort and expense.