World Relief's Debbie Dortzbach, a public-health professional specializing in HIV, and her husband Karl have worked in Africa since 1973. Based in Nairobi, Dortzbach is a leading developer of church-based AIDS initiatives. The Eleventh International Conference on AIDS—meeting in Vancouver, British Columbia in 1996—recognized her achievements. She discussed her perspective in a recent interview with Christianity Today:

Why are so many millions of Africans infected with HIV?

The epidemic is probably older in Africa than it is elsewhere. But this is the primary reason: the environment was very ripe for it. The sexual revolution of the 1960s and 1970s in the West spread globally and penetrated Africa. Some of the traditional and very sound cultural restraints that were present to curb promiscuity were broken down. Had this been in the 1920s or 1930s, I think it would have died out much sooner. Even in polygamous marriages, it was a contained unit. Urbanization has played a very significant role, because families have had to be separated. Men leave their families for up to a year. While they're away, the temptation is very, very great. Another is the displacement of people because of war. With that comes the complex nature of troop movements and their actions in camps. Some armies are notorious for promiscuity and rape. The health issue is another one. Without the opportunity for good healthcare or treatment of other sexually transmitted disease, the risk for contacting HIV jumps about eight times. The combination of all those factors has just caused this continent to be exploding with this virus.

Are Christians being infected at lower rates than non-Christians?

That's a hard question to answer, because it does hinge on the definition ...