A new study of great importance for HIV infected women is being designed by
the CDC (Centers for Diseases Control) as a sub-study of the HIV Epidemiology
Research Study (HERS). One of its objectives should be to detect and
quantify the presence of HIV in cervico-vaginal secretions.
Since the beginning of the AIDS epidemic the possibility of contracting HIV
through exposure to vaginal secretions has been regarded as a fact, although
no proof of it has ever been presented. As a matter of fact, this new study
may even come up with the surprising conclusion that vaginal fluids,
excluding the presence of menstrual blood, present minimal quantity of virus
and, like tears, are not capable of transmitting HIV infection. No data has
ever been reported to support one theory or another.
Finding the Truth
Finding the truth is vital to improve quality of life for HIV positive women
and their uninfected sexual partners. The mere possibility that vaginal
secretions may transmit the disease has brought tremendous stress into their
lives. The women's concern with their loved ones has even led the vast
majority of infected women to abstain from receiving oral sex as opposed to
the option of using a barrier such as dental dams or plastic wraps. Finding
out exactly how contagious vaginal fluids are can potentially bring more
confidence in the use of preventive methods and immediately relieve a great
deal of stress from their lives.
Where is the Data?
On April 17th at the CDC Women's Symposium in Atlanta, Dr. Clyde Hart
presented the initial design of the intended study. Opening his presentation,
Dr. Hart frivolously stated: "...exposure to cervico-vaginal secretions is
responsible for most transmissions to men." Throughout his speech, Dr. Hart
repeatedly reiterated the importance of the study to understand how to
prevent HIV infection among heterosexual males.
When asked where is the data to support his assumption that cervico-vaginal
secretion is the main cause of transmission to heterosexual men, Dr. Hart
responded that not being an epidemiologist himself, he does not have that
He then requested the epidemiologists in the audience to back him up with
some data. None of the top epidemiologists in the country who were attending
the symposium volunteered to bring up the data because of a simple problem:
it does not exist.
Infection in men though heterosexual contact occurs, that's undeniable.
Worldwide, the majority of infections are in the heterosexual population.
What is questionable is what exactly causes the transmission from female to
male. It may be virus present in menstrual blood, not necessarily in vaginal
secretions. Even in regions where the epidemic is devastating the
heterosexual population, the assumption still can't be verified. In such
places, like the African Continent, the use of anal sex as a method of
birth-control is customary, and rectal-bleeding presents a high risk of
exposure to HIV. Therefore, without measuring the amount of virus in
cervico-vaginal secretions, it is impossible to link it to heterosexual
transmission to men.
Dr. Hart's statement is not simply naive, it is irresponsible. He never
tried to conceal his sole concern with heterosexual males, and complete
disregard for homosexual transmission among lesbians, for whom the study is
of extreme importance. Women are once again seen as vectors of transmission
to men and deprived of human characteristics. We know by now that HIV
nurtures in ignorance. Spreading misinformation or information that has no
scientific data to back it up, neither helps to contain the epidemic or
improve the quality of life of the affected population, regardless of sexual
orientation. The search for the truth has to proceed with fairness and
consideration for all human beings.
No Input from Women
It is sad that such an important study ( H.E.R.S.), with potentially vital
consequences for infected women, has started under the influence of so much
bias and disregard for the actual available data. This kind of attitude from
the medical field only serves to emphasize the urgent need for input from the
HIV-affected community into the HERS study. It is unacceptable that such a
comprehensive and important study has so far been conducted without the
consultation of a Community Advisory Board of infected and affected women.
Until now, prayer is the only instrument given to the HIV community to assure
that HERS investigators like Dr. Hart will have a heart and treat patients
with respect and regard for their own issues. So help us, God!