DURHAM, N.C. -- The success of Uganda and Brazil in fighting AIDS in the 1990s suggests that government openness and a widespread education campaign may help prevent the spread of the disease, says a Duke professor who has studied AIDS in Africa.

"When I was studying AIDS in Africa in the 1990s, there were some countries that we thought were going to be devastated by the disease. We were thinking that literally generations were going to be wiped out. Brazil, in South America, was one of those countries, and Uganda was another," said Kathryn Whetten, assistant professor of Public Policy and Community and Family Medicine at Duke University. "But that didn't happen.

"We can't say for certain what worked, but we can say what was unique about these two countries' efforts to combat AIDS," she said.

Both governments took the AIDS threat very seriously, very quickly, and they weren't afraid to talk about sex and condoms, she noted. Both nations started widespread education campaigns, using various means to get educational messages to the people, such as having the biggest pop stars perform songs that were played over the radio. They used billboards, newspapers and other means to contribute to the discussion, she said.

She stressed that, while funds are important, what appears to work is open communication throughout the country about the nature of the disease and its modes of transmission, a discussion that transcends all of the different levels and beliefs of a culture. In Uganda and Brazil, this discussion was started from the top-down, but it can come from the grassroots as well, said Whetten, who is also the director of Duke's Health Inequalities Program in the Center for Health Policy, Law and Management.

"When I look at other countries at great risk now, we may find that their governments will be less inclined to be so open," she said.

Some of the worst problems appear to be in countries such as Cambodia, Thailand and Nigeria. China and India will be facing wide-spread HIV epidemics, she said.

"What is common among those countries, except for Thailand, is they are countries where the governments, including at the local level, have been very conflicted about what to do about HIV and the social stigma of the disease," she said. "There remains a strong feeling that if you talk about the disease at any level -- individual, family, community or national -- you are bringing shame."

Strong religious beliefs, regardless of the particular religion, are associated with an inability to take strong stances on engaging in open discussions about stopping the spread of the disease, she said.