by a fragmented response, mainly through nongovernmental organizations. On the other hand, some interesting and important social and behavioral research has been conducted in Tanzania. The AIDS epidemic in Cameroon is not as far advanced as in Zambia or Tanzania, and is characterized by a relatively low level of response. Although the country enjoys some limited social and behavioral research capacity, no prioritization of research needs has yet been conducted.

The visiting team included Deborah Rugg (Centers for Disease Control and Prevention), Carl Kendall (Tulane University), and Peter Way (U.S. Bureau of the Census), together with Barney Cohen (National Research Council). A fourth member of the panel, Dr. Eustace Muhondwa, joined the team in Dar es Salaam, and Peter Way left the team there for a brief visit to learn more about the situation in Kenya. Additionally, Dr. Tom Barton (UNICEF and Makerere University) was invited to join the team for 2 days in Dar es Salaam so he could brief them on the research needs assessment he had conducted for the Uganda AIDS Commission in October 1992.

The team met with the national AIDS control program managers in each of the three countries, as well as many other government officials, social and behavioral scientists, donors, university researchers, policy makers, caregivers, and employees of national and international nongovernmental organizations.

This appendix presents findings from the team's visits to Zambia, Tanzania, and Cameroon.1 For each, it presents an overview of the current HIV/AIDS situation, summarizes the history of AIDS-prevention efforts, describes ongoing prevention and mitigation initiatives, and reviews the state of social and behavioral research. The final section presents overall themes emerging from the visits to the three countries.

ZAMBIA JANUARY 23-27, 1995

Overview of Current HIV/AIDS Situation

In Zambia, the AIDS epidemic is already at an advanced stage and has become a major health crisis for the government. The first AIDS cases in Zambia were reported in 1984 and 1985. By 1986, the disease had been recognized as a major public health problem. Over the last 10 years, the number of AIDS cases has risen dramatically. Although exact figures are unreliable, the magnitude of the problem is enormous. Data are available from selected sentinel surveillance sites around the country for 1992, and preliminary data are available for 1993. These data indicate that HIV prevalence among sexually active adults in urban areas ranges from 15 to 37 percent in urban areas, with an average figure of


 A list of the people contacted by the team can be found at the end of this appendix.

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