Epidemiologist Dr. Rand Stoneburner (center), a 1971 graduate of PC, chats with Dr. Greg Henley and Dr. Jim Stidham prior to his lecture Tuesday in Belk Auditorium. PC grad says ´social vaccine' key to combating spread of AIDS Jan. 12, 2006 The AIDS pandemic has found at least a "social vaccine" in Africa that ought to be replicated and implemented worldwide, a leading epidemiologist and Presbyterian College graduate said this week. Dr. Rand Stoneburner, a 1971 alumnus of PC, lectured Tuesday on the magnitude and the possible halt the AIDS epidemic, the latter modeled after a program in Uganda aimed at avoiding risky behavior. Stoneburner, who currently is an independent health consultant associated with the Health Population Evaluation Unit of Cambridge University in England, has extensive experience researching and analyzing population-based disease surveillance and demographic data and their application to health policy. In 2005, he said, there were 4.9 million new HIV infections -- approximately 14,000 per day --, which now means that AIDS is the leading cause of death worldwide. Traditional prevention strategies have included condom use and educational programs, while treatment options have centered on antiretroviral drugs that have yet to be widely distributed throughout the world. Stoneburner said a lack of resources -- including money and training -- are challenges to combating AIDS. The United Nations, he said, has estimated that $12 billion, for instance, is needed immediately to combat the pandemic -- twice the amount that was spent last year alone. But what if a vaccine was discovered and not used? In Uganda, Stoneburner said, a "social vaccine" was seemingly implemented from 1989-95 that caused a sharp decline in AIDS. From 1985 to 2000, he said, AIDS cases in Uganda dropped 54 percent -- not because of Western-style programs with condoms and education but a dramatic change in at-risk behavior. On a trip to Uganda to investigate the causes of the behavioral changes in Uganda, Stoneburner made a startling discovery just talking to a native cab driver. "I told him why I was in Uganda and he starting telling me about the members of his family and friends who died of AIDS," he said. "In fact, he completely took over the conversation and couldn't stop talking about it. It was a process that was incredible." As researchers would learn in other countries like Malawi and Zambia, where AIDS still was prevalent, there still was a high level of behavioral risks -- especially casual sex and multiple partners, said Stoneburner. In Uganda, on the other hand, there was an increase in abstinence and fidelity and a more open and even personal style of communication that seemed to be strongly linked to the decrease in AIDS cases, he said. Uganda's homegrown program also had a clear "fear" message -- stay with your partner or abstain from sex altogether -- that was more effective than other countries' programs of testing and condom use. "So, why was this program not exploited elsewhere?" said Stoneburner. "It is estimated that Uganda's strategy could have saved an estimated 3.5 million lives. Unfortunately, though, it may have conflicted with other intervention paradigms or interests." Where Uganda employed fear and risk avoidance, other countries seem to resort only in risk reduction that allows people to maintain their current lifestyles in seeming denial of the AIDS epidemics in their countries, he said. But, he added, there is hope that Uganda's success can be replicated and there is evidence that similar programs are working in Kenya, Ethiopia, Zimbabwe and Tanzania. Stoneburner closed on a personal note to students interested in exploring the world outside their country's borders. "When I was sitting out there, I never knew I would take the journeys I've taken," he said. "I urge you to look at your world and take those journeys when you have the opportunities. They are quite educational."