Strategies for AIDS prevention and control in sub-Saharan Africa.

Abstract

Most countries in sub-Saharan Africa began routine reporting of AIDS to the World Health Organization (WHO) during or after 1987 and, as of May 1, 1991, more than 90,000 cases of AIDS had been reported from the region. The WHO, however, estimates based upon serological data up to early 1991 that more than 5 million adults in the region had been infected with HIV, of whom approximately 50% are women. Using that estimate, 1980 as the year when the extensive spread of HIV infection began, and assuming an adult progression rate from HIV infection to the onset of AIDS of 50% within 10 years, the WHO estimates that about 700,000 adult AIDS cases had probably occurred in sub-Saharan Africa by early 1991. The WHO further estimates that approximately 2 million children had been born to HIV-infected mothers in the region as of early 1991; more than 500,000 children are therefore thought to have been infected with HIV by early 1991. This paper considers preventing the sexual transmission of HIV, preventing HIV transmission through blood, and preventing perinatal HIV transmission. Objectives, strategies, and interventions to reduce the personal and social impact of HIV infection include providing health care to HIV-infected individuals, providing psychosocial support to HIV-infected people with and without AIDS, and promoting multisectoral actions to reduce the social and economic consequences of HIV infection. Challenges for the 1990s are discussed.