While the two programmes

UNAIDS

While the two programmes differed in their emphasis on particular preventive measures,
there were some noteworthy parallels underlying each programme’s success.
Thailand Uganda
Programme emphasis on condom use,
especially in sex work venues such as
brothels:
Did not discourage reducing number
of sexual partners
Thais reduced their number of sexual
partners, particularly those involving
commercial sex transactions
Public promotion of condom use led
to an increase in condom use and
a decrease in the number of sexual
partners, which was additive to the
increased condom use
Programme emphasis on partner
reduction:
Did not discourage condom use
Ugandans reduced their number
of casual sexual partners
Public debate about condom use
led to an increase in condom
use in the general population,
particularly among young people
and in sex work, which was
additive to the decline in the
number of sexual partners
The difference in programme emphasis between use of condoms and reduction in the
number of sexual partners appears more related to differences in local epidemiology—
namely differences in the prominence of commercial sex in HIV transmission—than to
differences in philosophy.
These two countries’ responses to the HIV epidemic were based on correct assessment
of the main factors driving their epidemics and an understanding of local sociocultural
characteristics. Thailand’s emphasis on condom use in sex work venues would not have
worked in Uganda as this factor was not driving the Ugandan epidemic. A Ugandanstyle
programme emphasizing partner reduction for the general population probably
would not have worked well in Thailand. In both cases, what did work was a determined,
multisectoral effort that enlisted broad public support and responded to local realities.