LONDON (AP) - Offering free sex counseling and HIV tests to people in the
developing world would curtail unsafe sex and could slash infection rates by
more than 10 percent a year at a reasonable cost, new research suggests.

Funding agencies have been reluctant to finance such programs, which are
widely used in the West, because no proof exists they would change sexual
behavior in developing countries. But now scientists for the first time have
gathered evidence that shows the programs are a good investment.

The research, published in the latest Lancet medical journal, was
commissioned by the United Nations and the U.S. government to determine
whether intervention would make a difference, especially as HIV treatment is
unaffordable outside the developed world.

"The answer is overwhelmingly yes," said Tom Coates, director of the AIDS
Research Institute at the University of California, San Francisco, who led
one of the two studies. "Risky behavior declined by 35 percent."

A total of 1,104 HIV infections were averted in Kenya for every 10,000 tests
done in the first year of an intervention program there, Coates added. That
equates to avoiding 11 percent of expected infections.

Philippe Van de Perre, a West African AIDS researcher who was not connected
with the studies, wrote in a commentary published in the same issue of The
Lancet that the research was "reliable and convincing," and settled the
question of whether such programs would work.

Experts estimate that 24 million people in sub-Saharan Africa have HIV and
that infections are growing by between 4 percent and 8 percent a year,
Coates said. Between 25 percent and 40 percent of the population already is
infected.

In Coates' study, which sought to determine whether the programs do any
good, the scientists recruited 3,120 single people and 586 couples in Kenya,
Tanzania and Trinidad.

"People came in droves. There is no lack of demand for this," Coates said.

The participants were randomly divided into two equal groups, with half
receiving counseling about their sex lives and HIV tests. A counselor
designed a tailor-made risk-reduction program that addressed behaviors such
as condom use inside or outside a stable relationship and reducing the
number of sex partners.

Those in the other half were given no HIV tests and watched a basic AIDS
education video and a demonstration on how to use a condom.

They were contacted again seven months later. Single men given the test and
counseling reported 35 percent less unprotected sex with non-primary
partners, while those who just watched the video improved their behavior by
just 13 percent, the study said. In women, the improvement was 39 percent in
the program group, compared with 17 percent in the video group.

The video group were then given counseling and testing, and another
follow-up was scheduled for all participants six months later.

The people who had originally been given the tailored advice and HIV tests
had maintained their improved behavior and the ones who had switched to the
more intense intervention showed improvements similar to the original group.

It would cost about $27 per person to give the HIV tests and provide
counseling, according to Michael Sweat of the Baltimore-based Johns Hopkins
School of Public Health, who led the study examining cost-effectiveness.

The cost per averted infection was $249 in Kenya and $346 in Tanzania,
similar to other AIDS interventions, such as treating other sexually
transmitted diseases. Targeting the program to those most at risk of AIDS,
people aged 20-35, would make it even cheaper, Sweat's study said.

Coates said it would cost about $350 million to roll out a counseling and
testing program across the continent.

Van de Perre, of the Organization of Coordination and Cooperation for the
Struggle Against the Big Epidemics in Burkina Faso, added that the challenge
is no longer to prove such programs work, but to make them accessible to
those who need them.

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