The Durban colloquium. A special report
Pisani, E.
Aids Analysis Africa 7(2): 2-5
1997
ISSN/ISBN: 1016-8974 PMID: 12290343 Document Number: 267582
In 1997, demographers and policymakers met under the auspices of the International Union for the Scientific Study of Population and the University of Natal to discuss HIV/AIDS prevention and control efforts. It became evident that these two groups have enjoyed very little dialogue previously and that each needed to change their attitudes towards the other in order to work together effectively to prevent and control HIV/AIDS. Planners must identify the research questions they want answered, and demographers must understand the political ramifications of their research activities. The mortality levels caused by HIV/AIDS in sub-Saharan Africa are drastically reducing life expectancy even in populations where the proportion of infected adults has remained a stable 8%. New evidence points to reduced fertility among women with HIV, which means that surveillance studies that test pregnant women may seriously underestimate the prevalence of the disease. The reduction in fertility may fluctuate at different stages of the epidemic and appears to increase with time. These factors will result in considerable changes in population growth and structure. The surveillance system to track the spread of HIV in sub-Saharan Africa is out of date and must be improved by regular cross-sectional measuring of infection rates to provide needed data about the maturing epidemic and to determine if rising incidence is being masked by stable prevalence figures. Participants at a recent UNAIDS workshop concluded that the easiest way to determine incidence is to concentrate on the youngest age group, but this approach also poses problems. Many of the children orphaned by AIDS are currently being cared for in extended families, which function as they did during previous periods of high mortality. In some areas, however, the ability of these systems to absorb the orphans has been exceeded.