United Nations - A year after the 189-nation General Assembly adopted a plan to halt the Aids epidemic, a UN report issued on Sunday said "dramatic changes" in sexual awareness and behaviour are still needed in many poor countries to stop the advance of the killer disease.
The report examined data from 39 countries in Africa, Asia and Latin America and concluded that while campaigns have raised awareness of the HIV virus and Aids in many developing countries, they have not had a major effect on people's behaviour - and their perception of risk.
"The results from this study highlight the enormous challenges lying ahead in the prevention of the spread of HIV/Ais," the report said. "Clearly, dramatic changes in sexual and reproductive awareness and behaviour in many less developed countries are needed in order to defeat the HIV/Aids epidemic."
The UN Population Division said it released the study on the first anniversary of the General Assembly special session - the first on a health issue - to provide a picture of HIV and AIDS awareness and behaviour among men and women of different ages in many countries. It was based on nationally representative surveys of about 5 000 households in each country, mainly done in the mid-to-late 1990s.
The General Assembly session highlighted the need to intensify international action, focus on prevention of HIV infections, and mobilise resources to fight the Aids pandemic.
Even in countries where HIV rates are high, the report found a large majority of men and women considered themselves at little or no risk of contracting Ais.
In several countries, such as the Dominican Republic, Eritrea and Niger, the proportion was 90 percent or higher, it said. In contrast, only in the Comoros did the percentage of women who believed they were at moderate or great risk of getting Aids reach the 50 percent mark.
"Also striking is the fact that in none of the countries surveyed did the level of education make a significant difference in the responses. This suggests that education has not been effective in making people aware of their own susceptibility to Aids," the report said.
"This very consistent finding suggests that the perception of risk is culturally conditioned and may involve considerable denial. Therefore, the notion of 'risk perception' needs to be directly addressed in broad public programmes," it said.
In all 39 countries, a large majority of those surveyed who had heard of Aids knew at least one way to avoid sexual transmission of the disease. The two ways most often mentioned were using a condom and having only one sexual partner.
But despite a great effort to promote the use of condoms to prevent Aids, the report said "over the years, the condom has not become more popular among couples".
In some countries in western and central Africa, "the difficulty in promoting the use of condoms is compounded by the fact that the large majority of women who are sexually active intend to become pregnant," it said.
Men were much more aware than women about sexually transmitted infections.
The study found that in some countries - including Benin, Burkina Faso, Chad, Mali, Madagascar and Niger - about half the women surveyed didn't know they could contract a disease through sexual contact. In half the countries surveyed, one quarter to one third of women respondents knew of no way to avoid getting Aids.
While Aids campaigns have significantly raised awareness in urban areas, the report said "existing programmes have done little, so far, to adequately inform the vast majority of couples who live in the rural areas of many African and Asian countries".