Text Explanations of ABC Guidance #1 Tables

Table 1

Program planners should recognize that the relative prevention benefits associated with A, B and C programs will vary across epidemic contexts with differing transmission dynamics. In the absence of this recognition, programmers risk responding to a "generalized" epidemic with a "generalized" response - one that lacks strategic focus in terms of both its target audiences and its behavioral objectives. This point is illustrated in the figure, which highlights large differences in the types of exposures that are significantly contributing to new infections in five countries. The transmission dynamics that contribute to infection across these different "exposure" types helps to highlight the strategic benefits of prioritizing different ABC objectives in different settings.

Transmission Through Concurrent Partnerships Image

This diagram illustrates how the efficiency of HIV transmission is dramatically increased in the presence of frequent sexual contact if such contacts are "concurrent" (overlapping). Since population-level survey data from many countries indicates that regular and "low-risk" (marital or cohabitating) partnerships have low levels of condom use, the "B" or partner reduction component of the ABC approach in a "generalized" epidemic is especially important.^6,16

Table: HIV prevalence by age group among men and women aged 15-49. Tebelopele VCT Centres,2003, Botswana*

*Note: 2003 Data through 30th September only.

The table depicts age and gender-specific HIV prevalence in Botswana and illustrates why activities must be associated with prioritized behavioral objectives. From the figure one can conclude that programs to reduce new infections in young women should focus on promotion of abstinence among young females, on reducing cross-generational sexual relationships, and on encouraging faithfulness and correct and consistent condom use among older males.

Ages 15 to 19
Women: 15.4 percent
Men: 1.2 percent

Ages 20 to 24
Women: 29.7 percent
Men: 8.4 percent

Ages 25 to 29
Women: 54.1 percent
Men: 29.7 percent

Ages 30 to 34
Women: 61.5 percent
Men: 49.9 percent

Ages 35 to 39
Women: 55.9 percent
Men: 59.6 percent

Ages 40 to 49
Women: 45.0 percent
Men: 56.9 percent