Continuing rises in the number of HIV infected people are not inevitable. Early and sustained prevention efforts can be credited with the lower rates in some countries. For example in Senegal there was effective an early prevention. Uganda has bought its estimated prevalence rate down to around SO At from a peak close to 14% in the early 1990's with strong prevention campaigns, and there are encouraging signs that Zambia's epidemic may be followingthe course charted by Uganda.

But elsewhere, where far less has been done to encourage safer sex, the reasons for the relative stability remain obscure. Research is under way to explain the differences between epidemics in different countries. Factors that may play a role include patterns of sexual networking, levels of condom use with different partners, the availabilityof condoms and promptness in diagnosing and curing other sexually transmitted diseases (which if left untreated can magnify 20-fold the risk of HIV transmission through sex).

The overall provision of condoms to sub -Saharan Africais only 4.6 per man per year, so another 1.9 billion condoms need to be provided If all countries are to have the same amount as the highest six countries in Africa. Botswam South Africa, Zimbabwe, Togo, Congo and Kenya are supplied with about 17 condoms per man aged 15 to 59 years. It would cost an estimated $47.5 million (£34m) a year to fill the 1.9 billion condom gap excluding service delivery costs and production. Relative to the enormity of the HIV/AIDS epidemic In Africa, providing condoms is cheap and cost effective.

However condoms are not without their drawbacks, especially in the context of a stable partnership where pregnancy is desired, or where it may be difficultfor one partner to suddenly suggest using condoms. For many individuals and couples in Africa, where HIV prevalence rates are high, finding out their infection status could expand their range of HIV prevention options.