Vaginal Secretions and Transmission--
Still Looking for An Answer

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 data.

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.

Viral Vectors

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.

Help

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!