Reprinted from International Journal of STD and AIDS, 2002 October 13(10):657-66
HIV in Sub-Saharan Africa Not Explained by Sexual Transmission
By Gisselquist D, Rothenberg R, Potterat J, Drucker E.
“An expanding body of evidence challenges the conventional hypothesis that sexual transmission is responsible for more than 90% of adult HIV infections in Africa.”
[Although written from an orthodox perspective of AIDS and with misguided ideas about the accuracy of HIV tests, the study abstracted here aptly highlights what doesn’t add up about “HIV transmission” in Africa. Apparently the researchers are unaware that no HIV tests are actually able to diagnose infection with HIV or that the antibodies formed in response to more than 60 different conditions—including pregnancy, immunizations, malnutrition, exposure to TB, malaria and many common African diseases—can cause positive reactions on the supposedly specific HIV antibody tests. It would serve the authors well to investigate the alleged accuracy of so-called HIV tests and the many cross-reactions documented to occur with non-HIV antibodies.]
An expanding body of evidence challenges the conventional hypothesis that sexual transmission is responsible for more than 90% of adult HIV infections in Africa. Differences in epidemic trajectories across Africa do not correspond to differences in sexual behavior. Studies among African couples find low rates of heterosexual transmission, as in developed countries. Many studies report HIV infections in African adults with no sexual exposure to HIV and in children with HIV-negative mothers. Unexplained high rates of HIV incidence have been observed in African women during antenatal and postpartum periods. Many studies show 20%-40% of HIV infections in African adults associated with injections (though direction of causation is unknown). These and other findings that challenge the conventional hypothesis point to the possibility that HIV transmission through unsafe medical care may be an important factor in Africa's HIV epidemic. More research is warranted to clarify risks for HIV transmission through health care.
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