The available evidence suggests that, for prevention efforts to succeed, many countries need to invest in information about the types and distribution of risky behavior in the population and, among those with risky behavior, the prevalence of HIV infection. However, fewer than 20 developing countries have carried out sexual behavior surveys. As recently as 1995, one-fourth of all developing countries had not yet initiated systematic monitoring of HIV prevalence. Equally critical, very few studies have attempted to measure both the costs and effects of programs and almost none have included the prevention of secondary infections as one of the benefits. But the future of the epidemic is not carved in stone.
Action now can save millions of lives.
Bangladesh, Indonesia, the Philippines, and most countries of the former Soviet Union, as well as vast areas of China and India, fall into this category. Immediate action to prevent infection in the groups with the highest risk can avert a widespread epidemic. Most of Indochina, Latin America, and West Africa, as well as Yunnan Province of China and about half of India have concentrated epidemics. Thailand's experience shows that concerted action focused on people with the riskiest behavior can have immediate impacts, even in a concentrated epidemic. The rate of HIV infection in these countries is high in the groups with the riskiest behavior, and 5 percent or more of the women visiting antenatal clinics are infected, indicating that HIV has spread widely in the general population.