Back in 1996, when this map first appeared inScientific American magazine, researchers argued that lack of male circumcision was the single best explanation for the extraordinarily high HIV infection rates seen in certain urban centers and Africa’s “AIDS belt” (highlighted in red).
Several other factors failed to explain the uniquely severe HIV epidemic in eastern and southern Africa. Among those considered were polygyny (men taking multiple wives); high rates of sexually transmitted diseases, as inferred from sterility rates; marriage at a relatively late age; and women taking part in business (these last three factors tend to be associated with premarital and extramarital sex). Prostitution, the use of injectable drugs, and homosexuality were also ruled out as major factors, being uncommon in these regions.
The AIDS belt has expanded southward since this map was made, but the link between high HIV prevalence and low circumcision rates remains clear. The challenge ahead, AIDS prevention experts say, is two-fold: to promote male circumcision while also persuading both men and women to avoid multiple concurrent sexual partnerships.
Map, Laurie Grace