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“We’ll no longer be hands-on,” Mr. Strong said.

Fear factor gone

About 130,000 Ugandans get HIV every year. Joshua Musinguzi, who heads Uganda’s AIDS-control program, said that’s far more being infected than the government can treat.

“There is need for continuous dissemination of information,” Mr. Musinguzi said. “Individuals have the power to make the correct decision if they want to. The menu is there: ABC.”

Uganda once earned a reputation for successfully putting in place a policy called ABC: abstain, be faithful, or use condoms. Students of a certain generation were shown videos of the devastating toll of AIDS on the human body and then told to postpone the first act of intercourse. Some believe the fear factor, now gone, was decisive in Uganda’s successful control of AIDS in the mid-1990s.

“They now see AIDS as much more like diabetes, one of these chronic diseases you can live with indefinitely,” said Timothy Kalyegira, a well-known Ugandan social critic.

The government recently added male circumcision to the plan against AIDS in response to studies showing the procedure reduces by half the risk among African men of getting HIV.

Officials want to circumcise 4 million men by 2015 in hopes that mass circumcision, as well as a persistent media campaign urging Ugandans to “get off the sexual network,” will reduced substantially the rate of new infections. They remain optimistic that U.S. support for AIDS treatment will be stable for years to come.

In April, three U.S. lawmakers touring Uganda with the humanitarian group CARE visited the clinic where Mr. Engole gets his medication. He told the lawmakers his story and thanked them for PEPFAR; some of the Americans hugged him in return.

“To see this man who has a second chance now at living a healthy life, raising a family and children, to me was a very humbling experience,” Rep. Barbara Lee, California Democrat, said after meeting Mr. Engole.

“It also was confirmation of the fact that United States foreign aid works.”