Identifying the causes of HIV/AIDS in Botswana
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Why has Botswana, arguably the best run country on the continent of Africa, with a stable, transparent, and legitimate government as well as a capable public health care system, nonetheless failed to stem the AIDS epidemic? This question, known as the Botswana Paradox, is addressed in this paper in part because of the policy implications for the United States Agency for International Development. Over a five-year period (beginning in January 2004), USAID will spend approximately $56 million dollars on HIV/AIDS prevention activities in Botswana under the President's Emergency Plan for AIDS Relief (PEPFAR). This paper addresses how PEPFAR funding should be targeted via a KAP (knowledge, attitude, practice) analysis. Data analysis show that the "KAP gap" (the greatest area of weakness) lies not with knowledge or with attitude, but with individual sexual practices. For PEPFAR funding to have maximum impact, recommendations are given that address the KAP gap and focus on changing individual behavior.