Scientists Challenge View Sex Fuels Africa AIDS Crisis
February 20, 2003
A team of international researchers said today that Africa's AIDS epidemic may not have been fueled mainly by sexual transmission of HIV but by unsafe medical injections and blood transfusions.Adapted from:
Most scientists believe heterosexual sex spreads HIV in up to 90 percent of adult cases in sub-Saharan Africa. But a team of eight experts from three countries who reviewed data on HIV infection in Africa estimate that only about one-third of adult cases are sexually transmitted. Health care practices, especially contaminated medical injections, could also be a major cause, they said.
"The idea that sex explains 90 percent of African HIV just doesn't fit the facts," said David Gisselquist, a Pennsylvania-based independent consultant and a member of the research team. "We need to take a look at the alternative explanations, in particular health care transmissions which seems to fit a lot of facts," he said.
The findings, published in the British Royal Society of Medicine's International Journal of STD and AIDS, were not accepted by all scientists. "The idea that dirty needles or blood transfusions are the main route for HIV transmission in Africa today flies in the face of experience on the ground," said Dr. Chris Ouma, head of health programs for ActionAid Kenya. "In Kenya, medical procedures have largely been made safe but still HIV infections continue to rise."
In three reviews in the journal, HIV specialists including Gisselquist, Francois Vachon of the University of Paris, and Devon Brewer of the University of Seattle, said the AIDS epidemic in Africa has not followed the normal pattern of STDs. In the 1990s in Zimbabwe, STDs decreased by 25 percent but HIV rose by 12 percent a year despite an increase in condom use by high-risk groups. The team argued that the virus is more easily transmitted through unsafe injections and tainted blood transfusions than through heterosexual sex. Surveys have shown that sexual activity in Africa is much the same as in North America and Europe, where HIV/AIDS rates are much lower. Studies have also identified HIV-positive babies whose mothers are not infected, also suggesting that unsafe injections could be a factor. "Every year there are hundreds of millions of unsafe injections in Africa where needles have been used on someone and re-used without sterilization," Gisselquist said.
This article was provided by CDC National Prevention Information Network. It is a part of the publication CDC HIV/Hepatitis/STD/TB Prevention News Update.