Leading scientists battling the world’s worst AIDS epidemic have called on African leaders to spearhead a month-long sexual abstinence campaign, saying it would substantially reduce new infections.
Epidemiologists Alan Whiteside and Justin Parkhurst cited evidence that due to “viral-load spikes,” a newly infected person is most likely to transmit HIV in the month after they were exposed to it. A month-long campaign could potentially cut new infections by up to 45 percent.
Whiteside’s research with Parkhurst, of the London School of Hygiene and Tropical Medicine, is anchored not in condom use but in studies of religious groups, such as Muslims who abstain from sex during Ramadan and Zimbabwe’s Marange Apostolic sect, which bans sex during Passover.
According to UNAIDS, predominantly Muslim countries such as Pakistan, Bangladesh and Indonesia have an HIV prevalence rate of 0.2 percent. The low rate has previously been attributed to the universal practice of male circumcision. However, Whiteside says that practicing Muslim men are also protected from HIV by the ban on sex during the daylight hours of Ramadan, as well as strict teachings on alcohol use, homosexuality and extramarital sex.
In stark contrast, predominantly Christian South Africa has an adult prevalence rate of 18.1 percent and 5.7 million people living with AIDS. Zimbabwe has a similar prevalence but members of the Marange sect have lower rates than the surrounding population. Swaziland has the highest number of infections in the world, with a rate of 26.1 percent.
Whiteside, of the University of KwaZulu-Natal, said he was seeking the support of kings and presidents.
“This would be a national campaign with buy-in from leadership at every level, from the president or king, through church leaders and business, down to community leaders,” he said. “This kind of initiative could provide hyper-endemic countries with a one-off, short-term adaptation that is cost-effective, easy to monitor and does not create additional stigma.”
Whiteside said a month-long pledge to use a condom could also be effective.
“The main thing is to agree on a bounded period in which the entire population would live by the same rule. The success of the World Cup in South Africa is proof that social mobilization can work,” he said.
“We see this kind of initiative as a way of breaking the cycle. We think a good month to do it would be during the southern African spring, in October or November. We would like to try it,” said Derek von Wissell, director of Swaziland’s National Emergency Response Council on HIV/AIDS.
He rejected suggestions that a campaign of abstinence would be perceived as moralistic or would be in danger of being hijacked by churches.