|Acting Early to Prevent AIDS: The Case of Senegal (UNAIDS, 1999, 28 p.)|
|Has the response made a difference?|
The behavioural data suggest, then, that sexual activity with multiple partners other than spouses is relatively low, and a high proportion of casual sex (including virtually all commercial sex) is protected by condoms. But again, most of this information relies on people reporting their behaviour accurately. Is there any other evidence to support these claims?
Yes. Since STDs are spread in the same way as HIV, they are a good marker of risk activity. And since they are curable, they usually reflect risk activity in the relatively recent past, whereas HIV infection may be caused by risk behaviour several years previously.
Figure 3. Sexually transmitted diseases among sex workers and pregnant women in Dakar, Senegal
A study of sexually transmitted diseases among sex workers and pregnant women in 1991 and 1996 showed dramatic falls in infection rates for all STDs measured, and for both groups of women, as Figure 3 shows.
These clinical findings confirm low reported prevalence of STDs. In a national DHS survey in 1997, just 0.7 percent of women and one percent of men reported having any STD symptoms in the past year. Since many sexually transmitted infections in women are asymptomatic, it is to be expected that women report lower levels of STDs than are found in systematic screening programmes. In a population-based study in the capital the same year, 2.3 percent of men reported any symptoms of STDs in the past year.
Fewer than half of all sex workers questioned in a 1998 study reported any STDs in the previous 12 months, and just eight percent reported more than one episode. However, it is worth noting that even these levels seem relatively high in the light of low levels of partner exchange and extremely high levels of condom use reported by sex workers in surveys.