Index

A

Abortion, 191, 217

Abstinence, sexual, 59, 62, 117, 119, 120, 135, 151, 188

Acquired immune deficiency syndrome. See AIDS

Adolescents.

See also Girls

AIDS stigmatization, 140

coercive sex, 8, 154

condom use, 147, 150

definition of, 182

interventions, 169-173, 198-203

peer information and pressures, 183

premarital pregnancy, 116

sexual behavior, 187

Africa Region Private Enterprise Development project, 238, 239

African Medical Research Foundation, 325

Age

and condom use, 126, 142

asymmetric matching of sexual partners, 61, 62, 77, 113, 116

and risk of HIV infection, 5, 126

and seroprevalence, 75, 76, 77, 79-80, 81

and sexual behavior, 126

Agriculture, impact of AIDS/HIV, 213, 233-234

AIDS

care for people with, 15, 185-186, 209-211, 318

database, 18

and discrimination, 187-188, 209

morbidity and mortality, 14, 69, 76, 216-218

number of cases, 1, 46, 70

origin, 70

AIDS awareness

asymptomatic transmission, 138

attitudes toward sufferers, 52, 140-141, 187-188

and behavior change, 9, 126, 137, 156, 228

modes of transmission, 136-137

perceptions of risk, 126, 138-140, 151, 212

and testing, 141

AIDS control programs, 49, 264

AIDS International Training Research Program, 260

Alcohol use, and risk of HIV infection, 94, 131

Anal sex, 8, 84, 92, 134

Awareness. See AIDS awareness

AZT, 14, 103, 192, 197



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Preventing and Mitigating AIDS in Sub-Saharan Africa: Research and Data Priorities for the Social and Behavioral Sciences Index A Abortion, 191, 217 Abstinence, sexual, 59, 62, 117, 119, 120, 135, 151, 188 Acquired immune deficiency syndrome. See AIDS Adolescents. See also Girls AIDS stigmatization, 140 coercive sex, 8, 154 condom use, 147, 150 definition of, 182 interventions, 169-173, 198-203 peer information and pressures, 183 premarital pregnancy, 116 sexual behavior, 187 Africa Region Private Enterprise Development project, 238, 239 African Medical Research Foundation, 325 Age and condom use, 126, 142 asymmetric matching of sexual partners, 61, 62, 77, 113, 116 and risk of HIV infection, 5, 126 and seroprevalence, 75, 76, 77, 79-80, 81 and sexual behavior, 126 Agriculture, impact of AIDS/HIV, 213, 233-234 AIDS care for people with, 15, 185-186, 209-211, 318 database, 18 and discrimination, 187-188, 209 morbidity and mortality, 14, 69, 76, 216-218 number of cases, 1, 46, 70 origin, 70 AIDS awareness asymptomatic transmission, 138 attitudes toward sufferers, 52, 140-141, 187-188 and behavior change, 9, 126, 137, 156, 228 modes of transmission, 136-137 perceptions of risk, 126, 138-140, 151, 212 and testing, 141 AIDS control programs, 49, 264 AIDS International Training Research Program, 260 Alcohol use, and risk of HIV infection, 94, 131 Anal sex, 8, 84, 92, 134 Awareness. See AIDS awareness AZT, 14, 103, 192, 197

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Preventing and Mitigating AIDS in Sub-Saharan Africa: Research and Data Priorities for the Social and Behavioral Sciences B Bacterial vaginosis, 90, 101, 196 Behavior change AIDS awareness and, 9, 126, 137, 156, 228 assessment of, 148-151 information/education campaigns and, 9, 156, 324-325 interventions, 9, 165 requirements, 158-159 vaccination and, 94 Botswana HIV/AIDS epidemiology, 46-47, 48, 73, 75 prevention efforts, 177-178, 179-180 sexual behavior, 62, 63, 113 Blood screening, 45, 97, 98 Blood transfusions, 82, 83, 97-98 Breastfeeding, 94-96, 135, 191 Burkina Faso HIV/AIDS epidemiology, 48, 78-79, 82-83 prevention efforts, 171 STDs, 90-91 Burundi AIDS awareness, 137, 138 condom use, 142-144, 146 HIV/AIDS epidemiology, 83, 121 impact of AIDS, 206, 207, 208-209, 233 prevention of AIDS, 142-144 sexual behavior, 114, 117, 121, 122-123, 126 C Cameroon AIDSCAP project, 330-332 HIV/AIDS epidemiology, 328 panel visit to, 328-332, 338-339 prevention efforts, 171, 245, 328-332 research capacity, 255, 257 sexual behavior, 63, 114, 129, 134, 135, 150 social and behavioral research, 332 STDs, 89, 129 Cameroon Psychology Forum, 332 Cape Verde, 78 CARE, 329 Casual sex, 110, 119-122, 127-128, 129, 151, 228-229 Central African Republic AIDS awareness, 137 HIV/AIDS epidemiology, 73 sexual behavior, 114, 116, 117, 126, 143-144, 149 STDs, 89 Cervical ectopy, 91, 92, 184 Cervical inflammation, 87 Chancroid, 84, 85, 88, 130 Childbearing. See also Pregnancy and pregnant women premarital, 62 social contexts for, 61, 120, 183 Children blood transfusions, 97 coercive sex with, 132 definition of, 182 educational impact of AIDS, 235 mitigation strategies for, 320-321 mortality rates, 96-97, 216, 218, 219, 220, 223 neonatal effects of STDs, 90 orphans, 14, 50, 97, 183, 186, 205, 214, 216, 223, 318, 320-321, 322 seroprevalence, 71, 94 Vitamin A therapy, 192-193 Chlamydia, 12, 67, 84, 85, 87, 89, 90, 100, 195 Circumcision, female, 130 Circumcision, male, 69, 92, 130-131 Civil unrest and wars, 66, 79, 132 Coercive sex, 8, 65, 132, 152, 154 Commercial sex, incidence of, 122-123 Commercial sex industry/workers condom use, 142, 145, 166 definitions, 63, 110, 122 economic factors in, 68, 124-125, 131 HIV seroprevalence, 65, 71-72, 74, 75, 79-81, 168, 180, 187 HIV-2 in, 78, 80, 82 interventions targeting, 63, 165, 166, 173, 178-179, 198-201, 331 migration and, 64, 65 and risk of infection, 93, 125-126, 136, 139 sexual contacts, 62-63 sexual practices, 134 STDs, 83, 85, 86-87, 129, 145, 179 surveys of, 112 women's status and, 61, 130 Community-based interventions. See Interventions

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Preventing and Mitigating AIDS in Sub-Saharan Africa: Research and Data Priorities for the Social and Behavioral Sciences Condoms access to, 66, 142, 145, 148 age of users, 126, 142 AIDS awareness and, 136 attitudes toward, 6, 8, 63, 64, 120, 141-142, 145-148, 167, 180 breastfeeding and, 135 female, 13, 174, 196 promotion of, 45, 155, 164, 165, 166, 167, 169, 170, 185, 324, 331-332 research recommendations, 8, 154 and sexual behavior, 141-148 and STD/HIV prevention, 92, 145, 178 use, 2, 63-64, 99, 112, 126, 136, 139, 142-145, 150, 152, 166, 167-168, 175, 178, 180, 190, 223 Congo, 89, 94, 96 Contraceptives, 13, 63, 91, 135, 167, 196, 223. See also Condoms Côte d'Ivoire AIDS awareness, 137, 139 condom use, 143-144, 147, 148 HIV/AIDS epidemiology, 47, 48, 71, 73, 75, 78-79, 81, 82-83, 121 impact of AIDS, 206, 216-217, 233 prevention efforts, 171, 245 sexual behavior, 114, 116, 117, 121, 122, 127, 149 sex ratios, 65 D Demographic and Health Surveys (DHS), 101, 110 Demography of HIV infection, 76-77 societal impacts of AIDS, 216-225 Drug abuse (injected), 98 Dry sex, 8, 92, 133-134 E Economic factors agricultural sector, 213, 233-234 business sector, 235-240 childbearing, 120 education sector, 234-235 family hardships, 211-214 family planning, 225-228 individual hardship due to HIV, 49-59, 209 and interventions, 156 health sector, 67, 205, 213-214, 231-233 per capita income effects, 50, 225-231 research constraints, 265-266 sectoral impacts of HIV/AIDS, 67-68, 231-235 in sexual behavior, 120, 124-125 structural adjustment programs, 68 Education (schooling). See also Information/education on HIV/AIDS access to, 184-185 and AIDS awareness, 137 and condom use, 142 higher-education systems, 257-258, 264-265 impact of AIDS/HIV, 234-235, 257-258 and risk of HIV infection, 127, 228-230 and sexual behavior, 116, 127 Epidemic extent of, 2, 46-47 societal contexts of, 3-4 spread of, 14, 47, 48, 64-66, 75, 93, 218; see also Transmission of HIV status of, 70-83, 204 Epidemiology behavioral data limitations, 98-100 biological factors, 69 demography of HIV infection, 4-5, 20, 76-77, 100, 216-225 geographic patterns, 1-2, 46-47, 65, 69, 79-80 social/behavioral research and, 100-101 statistics on AIDS/HIV, 70-76 Ethical issues, in STD/HIV research, 101-103 Ethiopia, 171, 187-188 Evaluation of AIDS programs, 162-163 Extramarital sex, 106, 119-122 F Families impact of AIDS on, 186, 211-216 organization, 58-61, 107, 110 Family AIDS Education and Prevention Through Imams Project, 186 Family planning, 9, 13, 63, 142, 156, 167, 190, 220-221, 223, 225-228, 229 Fertility/infertility, 63, 89, 90, 113, 130, 183, 191

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Preventing and Mitigating AIDS in Sub-Saharan Africa: Research and Data Priorities for the Social and Behavioral Sciences G Gabon, 89 The Gambia HIV/AIDS epidemiology, 78, 79, 81, 82, 83 sexual behavior, 109, 112, 142, 145 Gardnerella vaginalis, 90 Gender equality, 11, 167, 174-175, 194. See also Women's status Genital ulcer disease, 66, 81, 85, 86-87, 90, 91, 92, 178 Ghana AIDS stigmatization, 140, 208 HIV/AIDS epidemiology, 48, 82-83 impact of AIDS, 236, 237, 238 prevention efforts, 166, 172-173, 198-199 sexual behavior, 63, 108, 114, 116, 121, 128, 129, 132, 133, 135 Girls coercive sex with, 133, 152, 184 HIV incidence, 10 interventions, 184-185 risk of HIV infection, 91, 184 sexual behavior, 133 sugar daddies, 57-58, 112, 122, 184 Gonorrhea, 12, 67, 84, 85, 87, 88, 89, 90, 100, 130, 178, 195 Guinea-Bissau AIDS awareness, 136, 137, 138, 141 condom use, 143-144, 145, 149-150 HIV/AIDS epidemiology, 78, 79, 81, 82 prevention efforts, 198-199 sexual behavior, 108, 112, 114, 122, 126, 136 H Health care access to, 12, 66 AIDS treatment, 15, 209-211, 213-214, 231, 232, 318 costs, 213-214, 231, 232 economic issues, 204-205, 231-233, 266-267 HIV serological counseling, 66 insurance, 242 rationing, 232 STD treatment, 12, 66 Hemophilus ducreyi, 85 Herpes, 84 High-risk groups. See Risk of HIV infections, core populations Home-based care. See Health care, AIDS treatment Homosexuality, 84, 93, 134, 254 Human immunodeficiency virus (HIV). See also Seroprevalence Asia, 93 counseling, 13-14, 66, 102-103, 164, 165 n.4, 191, 197, 319, 331 cross-reactive immunity, 82 demographics of, 5, 76-77, 127 high-risk populations, 65, 71-72, 79 HIV-2 versus HIV-1, 52, 75, 77-83 incidence, 5, 80, 104 infectiousness, 82, 83-84, 91, 92, 145 isolation from genital ulcers, 86-87 latency period, 80, 212-213, 221, 224-225 and stigmatization, 208-209 susceptibility to, 4, 69 types and subtypes, 77-78 I Impacts of AIDS/HIV. See also Mitigation of HIV/AIDS impacts demographic, 14, 216-225 economic, 14, 49-50, 205, 209, 225-240 evaluation of, 15 family and friends of AIDS sufferers, 50, 186, 211-216 individuals infected, 207-211 projected, 50, 218-223 Information/education on HIV/AIDS and behavior change, 9, 45, 156 effectiveness, 3, 48, 51, 57, 164, 170, 172, 254 messages, 10, 155, 157, 171, 172, 193, 254 peer programs, 165, 179-180, 319, 330-331 in schools, 183-184, 187-190 targeting, 104 workplace programs, 319, 325 Institution-based interventions. See Interventions Interagency Working Group on AIDS, 218 Interventions adolescents (youth), 182-190, 198-203 behavioral, 2, 62, 160-161, 185 capacity-building for, 161

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Preventing and Mitigating AIDS in Sub-Saharan Africa: Research and Data Priorities for the Social and Behavioral Sciences case studies, 169-173, 178-182, 187-190 characteristics of reported programs, 198-203, 331-332 commercial sex industry, 63, 165, 166, 173, 178-179, 198-203 community-based programs, 13, 88, 163, 165-166, 198-201 contextual, 9, 53, 57-58, 150, 152, 156-157 effectiveness, 9-10, 54, 155-156, 164, 166, 172, 188-189, 221 empowerment of women, 176-178, 184-185, 194 evaluation of, 9, 10, 48, 54, 101-102, 162-163, 173, 188-189, 193-194, 242, 243 gender equality promoted in, 11, 151, 176 guiding principles, 160-161 institution-based programs, 13, 163, 164-165, 198-203 national programs, 18 need for, 2-3 population-based programs, 163, 166, 198-201 sexually active men, 166-173 sexually active women, 173-182 targeting, 76-77, 104, 160, 161, 168, 176, 185 typology of programs, 163-166, 169 K Kenya AIDS awareness, 137 HIV/AIDS epidemiology, 2, 47, 72, 73, 86-87, 88, 92, 94, 97, 103 impact of AIDS, 215, 232, 233, 236, 237, 238, 245 response to AIDS, 264 sexual behavior, 62, 108, 113, 114, 117, 125, 127, 134, 135, 143-144 STDs, 85, 86-87, 88, 89, 90-91 L Lesotho AIDS awareness, 137, 138 condom use, 143-144, 146 sexual behavior, 114, 117, 126, 127, 128, 149 Liberia, sexual behavior, 115 Life expectancies, 2, 14, 15, 47, 205, 218, 220, 223, 243 Lower-risk groups. See Risk of HIV infection, core populations M Malawi HIV/AIDS epidemiology, 46-47, 65, 73, 96 impact of AIDS, 220, 229, 232, 233 prevention efforts, 192, 198-199 sexual behavior, 63, 133-134 Mali HIV/AIDS epidemiology, 47, 82-83 sexual behavior, 115 Marital status and commercial sex, 124-125 and risk of HIV infection, 73, 81, 82-83, 127, 139 Marriage abstinence within, 117, 119 age differences in, 62 changes in social contexts, 61, 128 Levirate, 135-136 and sexual behavior, 58-59, 61-62, 108, 110, 112-113, 116-119, 121-122, 151, 181 virginity at, 107, 113, 116 Medical and program factors, 66-67 Menses, sex during, 92, 134, 135 Migration/migrants and behavioral change, 62 civil unrest and, 66 interventions targeting, 12, 195, 202-203 and risk of HIV infection, 128-129 and sexual behavior, 117, 128-129, 134 spread of HIV, 75, 82-83 rural-urban, 64-65, 66, 68, 76 young males, 64, 76 Military, interventions targeting, 164, 200-201 Mitigation of HIV/AIDS impacts cost-effectiveness of, 206, 242-243 counseling initiatives, 247-249, 319, 331-332 evaluation of interventions, 242, 243 health care, 210-211 orphan programs, 186, 320-321 providers, 16, 241-242, 244, 245-246 resource allocation to, 205-206

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Preventing and Mitigating AIDS in Sub-Saharan Africa: Research and Data Priorities for the Social and Behavioral Sciences targeting of assistance, 15-16, 241, 243-244 types of help, 186, 326-327, 242-243, 247 research recommendations, 14-16, 54-55, 243-244 Models/moderling, transmission of HIV and STDs, 91-94, 100, 171, 218 Monitoring HIV/AIDS behavioral/demographic variables in, 104 HIV incidence studies, 104 surveillance systems, 5, 103-104 Mortality AIDS, 14, 47, 204, 216-218, 223-225 infant/child, 96-97, 204, 216, 218, 219, 220 STD, 89 Mozambique, 66, 134 Mycobacteria hominis, 90 N Namibia, 48 Neisseria gonorrhoaea, 85, 89 Niger, 47, 115 Nigeria AIDS awareness, 136 condom use, 142, 145, 147 HIV/AIDS epidemiology, 48, 75 prevention efforts, 166, 198-199 sexual behavior, 62-63, 108, 109, 113, 115, 116, 120, 122, 123, 128 , 130, 132, 133, 134, 136 STDs, 130 Nongovernmental organizations. See also individual organizations intervention activities, 325-326 mitigation activities of, 245-250 social and behavioral research, 332 O Oral sex, 8, 134 Orphans. See Children P Parenteral transmission of HIV, 82, 83, 97-98 Pelvic inflammatory disease, 88, 89 Perinatal transmission of HIV, 13-14, 71, 78, 83, 90, 94-97, 103, 190-193, 197, 205, 216, 218 Polygyny, 59-60, 62, 113, 116, 117, 122, 128, 167, 168 Population growth, 14, 221-223, 225-228, 229, 230 Population Services International, 168, 324 Population-based interventions. See Interventions Pregnancy and pregnant women adolescent premarital, 116 cesarean section, 191 and HIV counseling programs, 13-14, 191, 197 HIV infection, 72-75, 81, 91, 174 immunosuppression of, 91 and STDs, 67, 85, 89-90, 91 vaginal lavage, 191-192 Premarital sex, 62, 63, 107, 112-116 Prevention of HIV/AIDS. See also Blood screening; Condoms; Information/education on HIV/AIDS; Interventions; Sexual transmission of HIV cost-effectiveness, 2, 13, 47, 196 donor fatigue, 3 economic conditions and, 156 initiatives, 45, 323-326 perinatal transmission, 14, 190-193 sexual transmission, 160-190 traditional healer component, 320 women's status and, 10 Private sector impact of AIDS/HIV on, 235-240 prevention efforts, 171 Prostitutes and prostitution. See Commercial sex industry/workers R Rape. See Coercive sex Recommendations. See Research recommendations Research in Africa. See also Social and behavioral research assessment of needs, 262-263 capacity-building, 16-19, 55, 251-270 community-based, 101-102 constraints on, 253-267 coordination, 18, 16, 19, 260-263, 270 databases, 254, 261, 269, 327 donor policies and practices, 16-17, 18, 19, 258-260, 263, 270

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Preventing and Mitigating AIDS in Sub-Saharan Africa: Research and Data Priorities for the Social and Behavioral Sciences economic conditions and, 265, 266-267 education systems and, 264-265 ethical issues in, 101-103 funding, 17, 19, 253-257, 262-263, 268 gender-specific, 175 infrastructure, 16, 265 international linkages, 17-18, 268 local resource use, 18-19, 269-270 manpower, 18, 255, 257-258, 268-269 political climate and, 19, 263-264, 270 prioritizing, 269 recommendations, 17-19, 267-270 social and behavioral, 19-20, 263-267, 321-322 validation of, 7 Research recommendations condoms, 8, 154, 196 cost-effectiveness studies, 13, 196 evaluation of interventions, 10-11, 193-194 HIV incidence studies, 5, 12, 104 impacts of HIV/AIDS, 15 interventions targeting migrants and disenfranchised, 12, 195 interventions targeting women and adolescents, 10, 193 female-controlled barrier contraceptives, 13, 196 gender equality interventions, 194 mitigation of HIV/AIDS impact, 15-16, 243-244 multidisciplinary approach, 5-6 operations research, 13, 196 pregnancy-related HIV counseling programs, 13-14, 197 research capacity-building in Africa, 17-19, 267-270 sexual behavior information collection, 7-8, 153-154 sexual networks, 152-153 STDs, 8, 12, 154, 195-196 surveillance systems for monitoring STDs/HIV, 5, 103-104 vaccination, 8, 154 vaginal microbiocide, 11, 194-195 Risk of HIV infection age and, 126 core populations, 65, 71-72, 93 economic conditions and, 68 education and, 127 models/modeling, 91-94 perceived, 126, 138-140 perinatal, 83, 94 residence, and, 71, 127-128 sex-related, 83-84, 125-131 structural adjustment programs and, 68 by type of STD, 86-88, 92 Roads, major, as corridors for HIV, 65-66, 75 Rwanda AIDS awareness, 138, 139-140 HIV/AIDS epidemiology, 50, 71, 83, 92, 94, 138, 223 impact of AIDS, 207, 233, 234 mitigation initiatives, 210 prevention efforts, 164, 165, 198-201 sexual behavior, 108, 115, 121-122, 125 S Sahel region, 135 Scarification, cosmetic, 98 Senegal HIV/AIDS epidemiology, 78, 80, 81, 82 sexual behavior, 112 Seroprevalence age and, 75, 76, 79-80, 81 blood donors, 97 commercial sex workers, 65, 71-72, 74, 75, 79-81, 168, 187 heterogeneity in, 4-5, 71, 75-76 and mortality rates, 223-225 pregnant women, 72-75, 81, 174 surveillance systems, 71, 103-104 trends, 14, 70-71 urban-rural differentials, 71, 73, 79, 223 young males, 2, 45 WHO estimates, 1, 69, 70-71 Sex education, 190 Sex ratios, 64-65, 128 Sexual behavior in sub-Saharan Africa. See also individual behaviors AIDS awareness and, 136-141 assumptions about, 59 beliefs and practices, 7-8, 99, 131-136, 151-152, 153, 183 change in, 148-151 coital frequency, 92, 111, 112, 118 condoms and, 141-148 data collection methods, 7, 106-112 implications of, 151-152 information on, 98-100, 106, 153-154

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Preventing and Mitigating AIDS in Sub-Saharan Africa: Research and Data Priorities for the Social and Behavioral Sciences initiation of sexual activity, 7, 111, 112-116, 128, 153 number of partners, 125-126 patterns of sexual activity, 62, 112-125, 153-154 perceived risk and, 126 reporting, 152 research needs, 7-8, 54, 153-154 risk factors in, 125-131 urban-rural differences, 127-128, 221 vaccination and, 154 women's status and, 174-175 Sexual networks. See also Marriage; Polygyny abstinence and, 135 elements of, 60, 61 and HIV transmission, 6, 61-62, 93 mapping, 150 research needs, 98-99, 152-153 Sexual transmission of HIV age factors, 61, 77 female-to male, 77, 84 male-to-female, 77, 83-84 models of, 91-94, 171 prevention strategies, 160-190 risk factors in, 4, 76-77, 83-84, 125-131, 158-159 sexual networks and, 61-62 STDs and, 2, 4, 12, 54, 69, 81, 82, 83, 84-94, 129-130, 132, 195 Sexually transmitted diseases (STDs). See also individual diseases and organisms attitudes and beliefs about, 8, 67, 130, 133, 154 control measures, 67, 142, 325 deliberate transmission of, 150 diagnosis and treatment, 12, 45, 66, 67, 87, 100-101, 129, 130, 145 , 164, 165, 169, 171, 172, 175, 181, 195-196 ethical issues in research, 103 health consequences, 51, 88-91, 130 and HIV transmission, 1, 2, 4, 54, 72, 79, 81, 82, 83, 84-94, 129-130, 132, 195 interventions, 12, 102 models of transmission, 91-94 monitoring, 103-104 prevalence and incidence in Africa, 64, 84-86, 179 reporting of, 67 research recommendations, 12 rural-urban migration and, 64, 65 socioeconomic implications, 90 synergy of HIV and, 85-88, 195 Sierra Leone, 214-215 Simian immunodeficiency virus (SIV), 78 Social and behavioral research education system and, 264-265 environment for, 263-267 epidemiological research combined with, 100-101, 104 initiatives in Africa, 321-322, 327-328, 332 limitations of existing data, 98-100 need for, 19-20, 50-51, 98-100 South Africa HIV prevalence, 65 impact of AIDS, 213-214 mitigation of AIDS, 210-211 sexual behavior, 65, 109, 116, 133, 134 Stigmatization, 8, 64, 67, 84, 140-141, 208-209 Sudan, 130, 134, 266 Surveys. See also individual surveys age cut-offs, 110-111 behavioral, 7, 106-107, 110, 149 bias, 110, 112 fertility, 89, 110 methodology, 106-111, 149 validation of, 110, 111-112, 153 Swaziland, 128 Syphilis, 84, 85, 89, 90, 125, 130 T Tanzania AIDS awareness, 137, 138-139, 140, 208 AIDS Control Program, 324-326 HIV/AIDS epidemiology, 47, 48, 65, 71, 73, 83, 88, 92, 103, 168, 183, 323 impact of AIDS, 207, 213, 214, 215, 229, 232, 233, 234, 235 mitigation initiatives, 210, 245 panel visit to, 323-328, 338 prevention efforts, 88, 142, 164-165, 172-173, 200-201, 323-326 research capacity, 254-257, 261-262, 327-328 sexual behavior, 111, 115, 117, 122-123, 126, 127, 128, 129, 142, 143-144 STDs, 2, 45, 88 Tattooing, 98 Testing for HIV attitudes about, 99, 141 and counseling, 102-103

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Preventing and Mitigating AIDS in Sub-Saharan Africa: Research and Data Priorities for the Social and Behavioral Sciences infants, 95 methods, 100, 104 Togo AIDS awareness, 136, 137 condom use, 143-144, 146, 147 sexual behavior, 115, 117, 126 Traditional medicine and healers, 98, 130, 165, 320 Transmission of HIV. See also Parenteral transmission of HIV; Perinatal transmission of HIV; Sexual transmission of HIV asymptomatic, 138 awareness about, 136-138, 156 deliberate, 150 primary mode, 4 Traumatic sex, 92. See also Coercive sex; Dry sex Trichomonas vaginalis, 85, 90, 195-196 Trichomoniasis, 12, 84, 85, 87, 101, 178 Truck drivers, 65, 164-165, 200-201, 325 U Uganda AIDS awareness, 140, 141, 150 condom use, 148 HIV/AIDS epidemiology, 2, 45, 46-47, 48, 50, 65-66, 71, 73, 76, 77 , 85, 93, 94, 96, 103, 168, 183, 216, 221 n.4 impact of AIDS, 206, 207, 213, 215, 217, 225, 233, 234 mitigation initiatives, 210, 211 prevention efforts, 165, 166, 186, 190, 200-201, 223 research capacity, 254, 257, 258, 261, 266 sexual behavior, 62, 93, 108, 109, 120, 127, 131, 133, 134, 136, 150 STDs, 85, 89 United Nations Children's Fund, 49, 318, 322, 329 United Nations Development Program, 49 United Nations Programme on AIDS, 3, 19, 270 Urbanization, 64, 128 Ureaplasma urealyticum, 90 U.S. Agency for International Development, 318, 324, 325, 328, 329 V Vaccination, HIV, 2, 8, 45-46, 51, 94, 139, 154, 267 Vaginal microbiocide, 11, 174, 194-195 Vas deferens occlusion, 89 Virginity, 107, 113, 116, 126 Vitamin A therapy, 192-193, 197 W West Africa. See also individual countries AIDS awareness, 136 HIV/AIDS epidemiology, 75 impact of AIDS, 207 sexual behavior, 116 women, 60-61 Women's status adolescent girls, 184 autonomy, 10, 60-61, 136 economic conditions and, 68 and HIV prevention, 10, 151, 173, 194 labor force participation, 60-61 marital status and, 61 and sexual behavior, 174-175, 184 widow inheritance, 136 World Bank, 49, 68, 207, 235, 318, 323 World Fertility Surveys, 89, 110 World Health Organization Global Programme on AIDS, 3, 49, 106, 187 seroprevalence estimates, 1 Y Young males interventions, 169-173 migrants, 64, 76, 128 seroprevalence, 2, 45 Z Zaire AIDS awareness, 138, 140, 141 HIV/AIDS epidemiology, 47, 48, 50, 68, 73, 75, 87, 94, 96, 180 impact of AIDS, 207, 213, 214, 215, 216-217, 232

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Preventing and Mitigating AIDS in Sub-Saharan Africa: Research and Data Priorities for the Social and Behavioral Sciences prevention efforts, 166, 169-173, 178-179, 200-201, 264 sexual behavior, 68, 108, 133 STDs, 87, 89, 179 Zambia AIDS awareness, 137, 138-139, 141 HIV/AIDS epidemiology, 2, 46-47, 48, 83, 94, 168, 223, 316-317 impact of AIDS, 215, 232, 234, 236 mitigation initiatives, 210, 211, 245, 319-321 panel visit to, 316-322, 337-338 prevention efforts, 142, 171, 183-184, 200-201, 317-319 research capacity, 262, 321-322 sexual behavior, 63, 115, 117, 126, 132, 133, 134, 142, 143-144, 151 STDs, 89-90 Zimbabwe AIDS awareness, 138 HIV/AIDS epidemiology, 2, 47, 48, 88, 96, 184 impact of AIDS, 214, 220, 221, 232, 236, 237, 238, 245 prevention efforts, 164-165, 166, 172-173, 202-203 research capacity, 261 sexual behavior, 62, 109, 112, 115, 123, 132, 133 STDs, 88