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AIDS prevention key to slowing epidemic

Volunteers teach survival strategies

July 12, 2000
Web posted at: 8:55 p.m. EDT (0055 GMT)

JOHANNESBURG, South Africa (CNN) -- Every Saturday the cemeteries near Soweto are busy with new arrivals.

About 30 or 40 people are buried every week, most of whom died of AIDS, funeral directors say. Few actually report the disease as a cause of death, however. It's a conspiracy of silence that is fueling the spread of HIV in sub-Saharan Africa, experts say.

With one of the fastest-growing infection rates in the world, South Africa has become the front line in the fight against AIDS. The only way to slow the epidemic, experts say, is to prevent new infections. In the United States and Europe, rates of new infection have declined, in part because of vigorous campaigns of public education on the importance of condom use, limiting sex partners and abstinence strategies.

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  • Find out more about the events planned at the 13th International AIDS Conference in Durban, South Africa
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    For in-depth coverage of the 13th International AIDS Conference in Durban, South Africa, watch Your Health on CNN Saturday, July 15 at 2:30 p.m. EDT and Sunday, July 16 at 3 p.m. EDT
     

    In South Africa, those same lessons face unique obstacles. Some countries, such as Uganda and Zimbabwe, have had successes. But here, volunteers help to get the word out.

    "We're here to tell everyone about HIV," says Dr. Mark Ottenweller, director of the Soweto AIDS Project for Hope Worldwide. "We feel like we're a drop in the bucket. We just want to be a big drop."

    Ottenweller came to South Africa 11 years ago from Atlanta, where he had a practice in internal medicine. Through his work with the Soweto AIDS Project, he knows the special challenges to AIDS-prevention education efforts there.

    "There are a number of cultural issues," he says. "Issues of women and children, issues of abuse, rape, violence ... a lot of our women have been beaten by their spouses or boyfriends."

    In what is largely a male-dominated society, women say they don't have the power to insist that their partners use condoms. But in areas where AIDS-prevention education is in place, those ideas are changing. Trials in Zimbabwe have increased condom usage from 2 percent to 70 percent after AIDS-prevention counseling, authorities there say.

    Still, old attitudes are difficult to overcome.

    An unemployed single mother of three whose partner left her, Zanhle Kaumall says she has problems asking men to practice safer sex techniques. "Others say ... if you want me to use the condom, I'd rather leave you and go to the next woman who won't say to me I must use the condom," she says.

    Her situation is very common. Experts estimate that as many as half of South Africans under age 20 -- some eight million people -- will not live to see age 35 because of AIDS. The risk factor for teenage girls is five times that for teenage boys, according to the United Nations AIDS Program.

    Michael Scholl is doing his part to teach young boys about AIDS while they also learn to play basketball.

    A sports attorney from Baltimore, Scholl works for an AIDS outreach program called LoveLife. His courtside lessons often include lessons on growing up healthy and strong.

    "Although it's just a game, it can teach you some principles that help in the real world ... hard work, discipline, determination, perseverance and a sense of teamwork," he has said of basketball.

    Other life lessons need frank talk, Scholl has learned.

    "Sex is an adult thing and we have to make decisions about our lives," he says. "We must be protected here in Africa."

    In Uganda, where AIDS prevention education is more widely available, transmission rates have been cut in half. In South Africa, AIDS workers hope to see similar success.

    CNN Medical Correspondent Eileen O'Connor contributed to this report.



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    RELATED SITES:
    Joint United Nations Programme on HIV/AIDS
    WHO Initiative on HIV/AIDS and Sexually Transmitted Infections (HSI)
    National Institute of Allergy and Infectious Diseases
    CDC-NCHSTP-Divisions of HIV/AIDS Prevention (DHAP) Home Page
    HIV | InSite | Home


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