Critique of early models of the demographic impact of HIV/AIDS in sub-Saharan Africa based on contemporary empirical data from Zimbabwe.

Early mathematical models varied in their predictions of the impact of HIV/AIDS on population growth from minimal impact to reductions in growth, in pessimistic scenarios, from positive to negative values over a period of 25 years. Models predicting negative rates of natural increase forecast little effect on the dependency ratio. Twenty years later, HIV prevalence in small towns, estates, and rural villages in eastern Zimbabwe, has peaked within the intermediate range predicted by the early models, but the demographic impact has been more acute than was predicted.

Impact and process evaluation of integrated community and clinic-based HIV-1 control: a cluster-randomised trial in eastern Zimbabwe.

Background: HIV-1 control in sub-Saharan Africa requires cost-effective and sustainable programmes that promote behaviour change and reduce cofactor sexually transmitted infections (STIs) at the population and individual levels.

Methods And Findings: We measured the feasibility of community-based peer education, free condom distribution, income-generating projects, and clinic-based STI treatment and counselling services and evaluated their impact on the incidence of HIV-1 measured over a 3-y period in a cluster-randomised controlled trial in eastern Zimbabwe. Analysis of primary outcomes was on an intention-to-treat basis.

HIV decline associated with behavior change in eastern Zimbabwe.

Few sub-Saharan African countries have witnessed declines in HIV prevalence, and only Uganda has compelling evidence for a decline founded on sexual behavior change. We report a decline in HIV prevalence in eastern Zimbabwe between 1998 and 2003 associated with sexual behavior change in four distinct socioeconomic strata. HIV prevalence fell most steeply at young ages-by 23 and 49%, respectively, among men aged 17 to 29 years and women aged 15 to 24 years-and in more educated groups.

Sexual mixing patterns and sex-differentials in teenage exposure to HIV infection in rural Zimbabwe.

Background: HIV-1 prevalence typically rises more rapidly at young ages in women than in men in sub-Saharan Africa. Greater susceptibility to infection on exposure in women is believed to be a contributory factor as is greater exposure to previously infected sexual partners of the opposite sex. We investigated the latter hypothesis using data from a field study in rural Manicaland, Zimbabwe.

Neuropsychiatric aspects of HIV disease progression: impact of traditional herbs on adult patients in Zimbabwe.

This cohort study examined the impact of phytotherapy (PT; traditional herbs) on neuropsychiatric aspects of HIV disease progression to antibody immunodeficiency syndrome (AIDS), CD4 counts, and viral load in adult patients in Harare, Zimbabwe. This is a community-based and nonintervention cohort study. The study was conducted in and around Harare City from June 1996 to May 1998.

Study of bias in antenatal clinic HIV-1 surveillance data in a high contraceptive prevalence population in sub-Saharan Africa.

Objective: To describe patterns, sources and consequences of bias in antenatal clinic (ANC) HIV prevalence estimates in a high contraceptive prevalence population.

Background: HIV surveillance in Africa relies on data from pregnant women attending ANCs. HIV estimates from pregnant women understate female infection levels in low income, high fertility populations.