Care and support for people living with HIV/AIDS

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Prevention: daunting challenges aheadFigure 22. Condom use for casual sex, by age, selected Latin Americanand Caribbean countries, 1996-19978070proportion reporting condom use withtheir most recent non-regular partner (%)6050403020ChileCosta RicaCubaDominican Republic10015-19 20-29 30-39 40-49age group (years)Source: National AIDS ProgrammesFigure 23. Condom use for casual sex in the past six months,17–30-year-olds, Switzerland, 1987-1997%100806040neversometimesalways20019871988198919901991199219931994199519961997Source: University Institute of Social and Preventive Medicine, Lausanne, Switzerland, 1999used a condom, while just 18% said they always did. Among those who were married,the men’s use of condoms with outside partners was similarly low and that ofthe women was even lower – over four out of five married women never used a condomwith men who were not their husbands. Most worrying of all were the relativelylow rates of condom use for very high-risk encounters. A study of sex workers in61
Report on the global HIV/AIDS epidemic – June 2000Kisumu, Kenya, showed that only half had used a condom with their most recentclient, and a third had never used a condom. Perhaps not surprisingly, given this lowrate of condom use, fully three-quarters of the sex workers responding to the surveyin this high-prevalence area of East Africa tested positive for HIV.One of the factors that influences condom use is alcohol consumption. In many continents,commercial sex and other risky encounters take place after drinking sessions.People who are drunk are less likely to use condoms than people who aresober. The consequences can be dire, as Figure 24 shows. In this South Africanstudy, the prevalence of HIV infection was far higher among men and women whoconsumed alcohol than among men and women who said they never drank. Thiswas true even among women in red-light districts.Figure 24. HIV prevalence rates among people consuming alcohol andamong non-drinkers, Carletonville, South Africa, 1998706050HIV-infected (%)4030drinkersnon-drinkers20100menwomenwomen in commercial sex areasSource: Campbell et al. (unpublished data)In Zambia, close to a quarter of women and a fifth of men with casual partners saidthey had been drinking the last time they had sex with their casual partners. In westernKenya, most sex workers questioned said that alcohol was involved the first timethey ever sold sex, and the overwhelming majority of sex workers in the town ofKisumu said that alcohol was an integral part of sexual transactions, with men buyingwomen a drink to signal their interest in buying sex. They also said condom usetended to evaporate when either the client or the sex worker was drunk. Studiesamong men in Europe, Mexico, Zimbabwe and Uganda have also shown a strongcorrelation between frequent use of alcohol and other drugs and unprotected sex.62
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Report on the global HIV/AIDS epide
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AIDS in a new millennium: a grim pi
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Annex 1.How reliable are estimates
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Table of country-specific HIV/AIDS
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Care and support for people living with HIV/AIDS

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