Change in men's behavior seen in fight against AIDS

DURBAN, South Africa -- In the AIDS prevention world, many lament that the behavior of men drives the pandemic and can't be changed significantly. But a series of studies presented at the US President's Emergency Plan for AIDS Relief's annual meeting yesterday suggested that men shouldn't be written off in fighting the disease.

One evaluation of a group in South Africa that promotes men's support organizations found that 92 percent of those surveyed encouraged their pregnant partners to get health checkups before giving birth. Another survey in Zambia found that many truck drivers said they were faithful to their wives or girlfriends after years of educating them about the dangers of having multiple partners.

And one group in Tanzania used theater to promote the fidelity message.

``You can reach men through their peer groups to promote behavioral change," said Richard Kaballa , a researcher at Muhimbili University College of Health Sciences in Dar es Salaam, Tanzania . ``We used a play that had a ghost as a character. The ghost went around touching those who hadn't been faithful. The message was if you are faithful to your partner, you won't be touched by the ghost."

The discussion was part of the US government's third annual AIDS meeting, which reflected the rapid growth of President Bush's $15 billion, five-year initiative. Just 100 US officials and AIDS experts attended the first meeting in 2004, and about 500 the second. This year's gathering, in the South African seaport city of Durban, has attracted more than 1,100 people involved in US anti-AIDS programs.

After the first two years' intensive focus on ways to quickly ramp up AIDS treatment programs, much of the attention at this year's five-day meeting is on promoting prevention messages that work. United Nations AIDS officials estimate that 14,000 people are infected each day around the world, while 8,000 people die daily from AIDS.

``We need much more effort on prevention," Alex Coutinho , executive director of The AIDS Service Organization in Uganda , said in yesterday's speech. ``I use the example of if you go to your house, find that it is flooded, what do you do first: turn off the tap or mop the floor? You turn off the tap first."

US government officials and AIDS program workers gave presentations on a wide range of prevention issues, from HIV testing to preventing the transmission of the virus from mother to child .

A session on men's behavior drew an overflow crowd. Prudence Ditlop , of South Africa's Population Council, an independent research group, found a few positive indicators that the Men as Partners program in the township of Soweto, south of Johannesburg, was having an effect on men's behavior. Her study of 920 men and 1,589 women found that roughly two-thirds of the men had been tested for HIV, and that 84 percent of the men and 85 percent of the women had discussed the results of test with their partners.

But even though more than nine out of 10 men in the Soweto study encouraged their partners to get prenatal care , just 54 percent of the women said the men accompanied them.

In Zambia, a six-year effort to educate long-distance truck drivers about the dangers of risky sex found a startling increase in the numbers of drivers who said they were faithful to their partners. In 2000, a study of 568 drivers found that 0.3 percent said they were faithful. Earlier this year, a study of 1,002 drivers at the same sites found that 63.8 percent reported being faithful to their wives or girlfriends.

The audience of scientists, researchers, and public health specialists seemed amazed by the change. Several publicly doubted the difference was that great. Said one male researcher from his seat: ``If you asked me if I had extramarital relations, my answer would be no, no, always no."

His comments drew laughter. But afterward, researchers said the studies showed hope that with programs, men could change, lessening the risk of transmission .

``It's encouraging that men can hear the message and change behavior," said Shepherd Smith , founder and president of Institute for Youth Development , a Washington-based group that promotes abstinence to prevent the spread of HIV. ``I think some of these programs are really getting into men's heads. I think it shows that fidelity and respect can be taught, and that even ghosts can help out."

John Donnelly can be reached at donnelly@globe.com.