HIV counselling has been proved effective in various ways. An evaluation of The AIDS Service Organisation (TASO) in Uganda has shown that it helps people accept and cope with the knowledge of being HIV-positive, and furthermore encourages acceptance from families and communities. A Rwandan study has proved that HIV counselling can help people make decisions about HIV testing, as well as reduce HIV transmission. Yet there is a reluctance among some policy-makers and service managers to give counselling its proper due as a discipline in which trained practitioners can produce measurable, useful results. For this reason it is under-resourced and not fully appreciated.

This report documents a regional workshop on surveillance systems for HIV held in Nairobi, Kenya, on 10-13 February 1997. The UNAIDS-funded workshop gathered government epidemiologists, AIDS programme managers, and social scientists from Kenya, Malawi, Swaziland, Tanzania, Uganda, Zambia and Zimbabwe as well as specialists from UNAIDS and other partner institutions. The group aimed to present current data and to work together to suggest practical guidelines for improving HIV surveillance systems in a maturing epidemic.

This 1998 report from the UNAIDS Best Practice Collection demonstrates the importance of collecting adequate data and undertaking efforts to monitor risk behaviour and HIV prevalence can help make the response to the AIDS epidemic within a country more effective. In Uganda the impact of the epidemic was recognized early and the government and all civil society partners reacted effectively to reduce its impact.

Military personnel are a population group at special risk of exposure to sexually transmitted diseases (STDs), including HIV. In peace time, STD infection rates among armed forces are generally 2 to 5 times higher than in civilian populations; in time of conflict the difference can be 50 times higher or more.

Provisional report Geneva Switzerland 26 June 1998

Around 340 million new cases of curable sexually transmitted diseases (STDs) are estimated by the World Health Organization (WHO) to have ocurred throughout the world in 1995 in men and women aged 15-49 years. In developing countries, STDs and their complications rank in the top five disease categories for which adults seek health care. In women of childbearing age, STDs - even excluding HIV - are second only to maternal factors as causes of disease, death and healthy life lost.

People with advanced HIV infection are vulnerable to infections or malignancies that are called “opportunistic” because they take advantage of the opportunity offered by a weakened immune system. Various treatments and prophylaxis—some simple and low-cost, others highly complex and expensive—exist to counter the most common opportunistic diseases, but delivery systems and funding are insufficient in many parts of the world to ensure their universal use.

Millions of lives are saved each year through blood transfusions. Various shortcomings, though, in the way blood is collected, tested (or not tested) for infections such as HIV, and transfused, mean that people in many countries have an increased risk of becoming infected with HIV andother diseases through transfusions. It is estimated that between 5% and 10% of all HIV infections worldwide have been acquired through transfusion of contaminated blood and blood products. If the proper steps are taken, such infections can be easily prevented.

Since 1985, HIV testing has been essential in securing the safety of blood supplies, monitoring the progress of the epidemic and diagnosing individuals infected with the virus. Various assays are now available, allowing testing strategies to be tailored to the epidemiological conditions and budgets of national health systems. New techniques including simple tests giving instant results hold great promise, but also raise some serious issues for governments and for individuals.

Sex between men occurs virtually in most societies. It is often stigmatized by society, and its public visibility, therefore, varies considerably from one country to another. Sex between men often involves anal intercourse, which carries a high risk of HIV transmission. Good HIV programmes addressing men who have sex with men (MSM) are thus vitally important, though up to now they have often been seriously neglected.