AIDS IN RURAL AFRICA - A PARADIGM FOR HIV-1 PREVENTION

Networks of concurrent sexual partnerships may be the primary cause of epidemic spread of HIV-1 in parts of sub-Saharan Africa. This pattern of sexual behaviour increases the likelihood that individuals experie ncing primary HIV-1 infection transmit the virus to other persons. Net works of concurrent partnerships are likely to be important in both. t he early ('epidemic') and late ('endemic') phases of HIV-1 transmissio n. interventions should aim to break the sexual networks, whatever the stage of the epidemic. However, prevention of transmission in the end emic phase also requires a greater awareness of early clinical manifes tations of HIV-1 infection in the general population. Such awareness, coupled with the availability of condoms and access to HIV-1 testing f acilities, may reduce transmission in discordant couples.