El SIDA en África: Zimbabwe

El virus del sida (VIH) ha acortado la vida en unos 20 años en Africa. Un estudio dirigido por Simon Gregson, del Imperial College de Londres, ha evaluado el impacto del VIH sobre la población de Zimbabwe y las predicciones sobre el SIDA en las poblaciones subsaharianas.

Un grupo de epidemiólogos de la OMS ha calculado que el crecimiento poblacional sera negativo en Zimbabwe. Aunque las infecciones mortales se han reducido, la tasa global es de 1%. En el medio rural de Zimbabwe la vida se ha acortado 19 años en los varones y 22 años en las mujeres. La evolución en ese país es representativa de lo que ocurre en otras regiones africanas.

En la actualidad hay 40 millones de personas infectadas por el VIH, y con los tratamientos se tiene cierta esperanza para mejorar la supervivencia.

UNICEF ha iniciado un programa de formación para los maestros y ellos diseminen medidas preventivas contra el contagio de VIH. A continuación detalles:

UNICEF on Monday launched a weeklong, $500,000 program in Zimbabwe aimed at training 1,500 primary and secondary teachers on how to provide HIV prevention education, UN News Service reports. About 500,000 children will participate in the program, which will focus on teaching life skills for HIV prevention, addressing gender dimensions of HIV, fighting sexual gender-based violence and providing counseling.

The program also will help teachers to understand and handle their vulnerability to HIV and will examine prevention, care, support and treatment, UN News Service reports. The program will be held at seven teaching colleges in Bulawayo, Harare, Masvingo, Mutare and Mutoko. A similar program last year trained 1,200 teachers from 18 districts. The training will be provided by UNICEF; the Ministry of Education, Sport and Culture; the Ministry of Higher and Tertiary Education; and VVOB-ZimPATH, a Flemish HIV/AIDS education project.

Evaluating the proximate determinants framework for HIV infection in rural Zimbabwe.
Lewis JJ, Donnelly CA, Mare P, Mupambireyi Z, Garnett GP, Gregson S.
London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK.

BACKGROUND: Risk factors for HIV infection can act at one of several causal levels, making interpretation of results problematic. One suggested solution has been a proximate determinants framework, in which risk factors are grouped into "underlying", "proximate" and "biological" determinants. METHODS: A baseline, cross-sectional survey of HIV serostatus and potential risk factors was carried out among 9480 adults in Zimbabwe. Associations were assessed separately for men and women using logistic regression models; data were only included for those who reported sexual debut. The predictive ability of proximate determinants describing both individual and partnership characteristics was assessed along with that of the underlying determinants. The significance of the underlying determinants once adjusted for proximate determinants was then evaluated. Finally, the relationship between the underlying determinants and some of the key proximate determinants was explored. RESULTS: The two most important proximate determinants for men and women were lifetime number of sexual partners and symptoms of sexually transmitted infections (p<0.001). After adjustment for all proximate determinants, some underlying determinants were still significant, particularly age group, marital status and community (p<0.001). CONCLUSIONS: Although proximate determinants could explain the action of many underlying determinants, several of the latter remained significant after adjustment for the proximate determinants. Hence, the proximate determinants were probably not measured completely. An important determinant of an individual's risk of HIV infection is the HIV status of their sexual partners. This was not measured in this survey, and may be related to the individual's age (as a predictor for the age of the partner), marital status and community prevalence. However, it will be measured in a subsequent survey of this cohort.

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