Africans are Main Victims of the Global Spread of AIDS

NAIROBI, Kenya (AP) _ By the time Ronnie Mutimusekwa was 15, he was sleeping regularly with three different girls. A few years later, the number had grown to 15 and he was proud to think any woman he asked would go to bed with him.

″I guess I made sex a hobby,″ said the 34-year-old.

A deadly hobby.

Mutimusekwa, from Zimbabwe’s southern city of Bulawayo, contracted AIDS. He does not know who gave it to him, nor does he know who may have caught it from him.

Behavior like his has contributed to the rapid spread of the disease in Africa, and has helped make the continent the AIDS center of the world.

Two-thirds of the world’s estimated AIDS cases are in Africa, and most of those are concentrated in about 12 countries across the continent’s central, eastern and southern regions.

The problem only threatens to get worse, according to medical experts. Infection rates, unlike those in most other areas of the world, are rising in Africa. If current trends continue, millions of African infants will be born with the deadly disease, and Africa’s population growth rate - now the world’s highest - will be cut as AIDS kills those in what should be the most productive time of their lives.

The Geneva-based World Health Organizaton estimates that in sub-Saharan Africa, one of every 40 adult men and women is infected with the HIV virus that causes AIDS. In the United States, which has recorded about half the world’s known cases of AIDS, one of every 75 men and 700 women has HIV, WHO estimates.

Because of under-recognition, under-reporting and delays in reporting, WHO estimates only a fraction of the world’s cases of AIDS and HIV have been recorded.

As of mid-1990, about 65,000 AIDS cases had been reported from Africa. But WHO estimates closer to 500,000 adult AIDS cases probably exist - more than half the estimated global total.

In what it calls a conservative estimate, the organization says 5 million Africans may be HIV carriers.

″AIDS and HIV are becoming more and more a disease of the developing world,″ said Michael Merson, WHO’s anti-AIDS chief, in a telephone interview from Geneva. ″By the year 2000, we expect 80 percent of the cases to be in the developing world.″

The organization says about 25 million to 30 million cases worldwide are expected by the end of the century.

Merson includes Latin America when he speaks of AIDS and the developing world, but WHO statistics show the severity of the disease in Africa far outstrips any other continent.

Today, AIDS is the leading cause of death among young adults in many African countries, said Merson.

The average African victim, however, differs from his American or European counterpart, who is usually a homosexual or an intravenous drug user. In Africa, most AIDS casualties are heterosexuals. Because of this, the number of women infected roughly equals the number of men.

And because many of the infected women are in their prime, HIV transmission from mother to child is an increasing problem.

Already this year, about 500,000 children carrying the HIV virus have been born in Africa, says WHO. The organization estimates an additional 10 million infected infants will be born before the year 2000. Another 10 million children born to infected mothers but who will not contract the disease are expected to become AIDS-related orphans in the 1990s, says WHO.

Dambudzo, a 26-year-old unemployed Zimbabwean, lost a 2-year-old daughter to the disease. The divorcee said she learned she had AIDS while still in the hospital after delivering her baby.

″I was really hurt because the baby had also contracted the disease and whenever she was brought in for breast-feeding, I would look at her and cry,″ Dambudzo told Ziana, Zimbabwe’s news agency.

Dambudzo’s husband also tested positive for the disease. But rather than engage in safer habits, she said he stopped sleeping with her and started bringing other women home to bed.

Such negligent promiscuity, as well as a tradition of polygamy among many African peoples, a high incidence of other sexually transmitted diseases, particularly those that create sores, and centuries-old customs are encouraging AIDS’ spread.

In Zambia, for instance, where 3,000 AIDS cases have been recorded but many times that are believed to exist, a custom among the Kaonde tribe demands that when a man dies, a male relative must sleep with the widow to exorcise ghosts.

Enough people will be dying of AIDS in the next 10 years that African population growth rates, the highest in the world, are expected to slow, says WHO. Beyond the year 2000, if current trends continue, populations could even decline, according to the U.N. organization.

Already along the east-west corridor of countries from Kenya to Ivory Coast, the hardest-hit West African country, villages are being decimated by the virus.

In southeastern Uganda, where the majority of that country’s AIDS cases have been recorded, residents of Rakai said as many as six people were dying daily by 1988.

Fred Ssonko, manager of a local hotel, said at the time he was going to burials ″almost every afternoon.″

The 35-year-old took on the extra care of eight children he adopted after his brother and his best friend died of the illness.

While education and awareness programs have changed behavior and slowed the rate of new infections in Europe and America, the rates are increasing at an ″alarming rate″ in African and other Third World countries, according to WHO.

Despite internationally-funded AIDS prevention programs throughout the continent, Africa still lacks the resources to mount educational campaigns that reach all its 500 million people.

″We know that a lot of people know about HIV and AIDS. But we don’t know enough yet about getting their behavior to change,″ said Merson.

″We want to get safer sexual practices and more condoms used,″ he said. ″And it’s very important to treat other sexually transmitted diseases.″

However, even some of those most at risk and who are easily accessible still don’t believe AIDS is a real threat.

Surveys have found that 60 percent to 80 percent of the prostitutes in some large east and central African cities are infected with HIV.

However, in Kenya’s capital, Nairobi, some prostitutes interviewed recently by a local paper said they thought the figures were just propaganda for government-backed family planning programs.

One AIDS prevention program being run by the Nairobi-based African Medical and Research Foundation (AMREF) is targeting a highly vulnerable population that health workers credit with fueling the virus’ spread: long-distance truckers.

Since the disease first was recorded in Africa in 1983, medical researchers have found AIDS spreading most quickly along trucking routes, with a high incidence of cases at popular roadside stops through southern, eastern and central Africa.

AMREF is distributing free condoms to the local prostitutes there and to drivers who frequent them as well as handing out pamphlets that explain AIDS’ causes and symptoms. The material urges the truckers to refrain from casual sex.

Ominously, while AIDS used to be concentrated primarily in urban areas along major roads, it is now appearing in rural areas where an estimated 75 percent of the population lives.

″It means the epidemic is continuing to rise and Africa is being confronted by a major problem,″ said Merson. ″It is nowhere near its peak.″