Why has HIV spread so rapidly in southern Africa?

Zimbabwe, like most countries in southern Africa, has one of the most devastating HIV epidemics seen to date According to available information, HIV is thought to have begun to spread rapidly within Zimbabwe in the mid-1980s with adult HIV prevalence reaching approximately 9% by 1990. The most recent published sentinel surveillance figures for Zimbabwe suggest that the national level of HIV prevalence among women attending antenatal clinics increased from 29% in 1997 to 35% in 2000. Even after adjusting for likely selection bias in sentinel sites, it was estimated that HIV prevalence amongst adults in Zimbabwe had increased from 25% to 30% during the intervening 3-year period. In trying to explain this trend most analysts have focused on behavioural and sociological aspects of why HIV has spread so rapidly in southern Africa. These include studies on patterns of infection and demographic impact by socio-demographic risk group and relative levels of HIV infection among more and less educated people. A comprehensive review of HIV/AIDS in southern Africa has recently been produced covering a broad perspective of the problem, ranging from epidemiology, psychosocial and cultural determinants, government policies and country level experiences. This paper examines social and biomedical perspectives in an attempt to provide plausible explanations of the rapid spread of HIV in southern Africa. The Zimbabwe Science News Volume 35 (1+ 2) 2001, pp. 11-1