Thursday, August 19, 2010

UNAIDS: HIV, Your Name is Africa

This blog is beginning to sound like Dr Chasuble in The Importance of Being Earnest, whose sermon on the meaning of manna in the wilderness could be adapted to almost any occasion. But the theme of the 'behavioral paradigm', the view that almost all HIV is transmitted by heterosexual behavior in African countries, must be discussed over and over again. That's because the consequences of adherence to this paradigm are many, and extremely serious. It leads to a misconception of HIV that drives the epidemic.

If you explain a massive HIV epidemic like that in Swaziland by reference to sexual behavior, you thereby stigmatize every Swazi who is HIV positive. Because roughly one quarter of sexually active Swazis are HIV positive, every sexually active Swazi could eventually become infected, and also stigmatized. The entire population of Swaziland, along with most other Africans, is stigmatized by the behavioral paradigm, the backbone of the HIV industry's ostensible theory of how HIV is transmitted in Africa.

To accept the behavioral paradigm and declare oneself to be opposed to stigma is a crude contradiction. The behavioral paradigm is the source of HIV related stigma. According to it, if you are a HIV positive African, you have almost definitely engaged in unsafe sex. You cannot, logically, be opposed to stigma and at the same time adhere to the behavioral paradigm, either through argument or through action. In fact, you could go further; if you are African, you are HIV personified, according to the HIV industry. Because you are unsafe sex, the product of it and the perpetrator of it.

Unsafe sex is, of course, an undesirable thing, regardless of whether HIV transmission is involved. There are many sexually transmitted infections (STI) one can catch and there is also the possibility of unplanned pregnancy. It's not called 'unsafe' sex for nothing. But neither is all sex is unsafe. Even those who have no moral objection to sex between consenting adults would warn against taking such risks. And, contra the HIV industry, unsafe sex, as well as sex, occurs in every country in the world. But hyperendemic HIV doesn’t.

Non-consensual sex should never be tolerated and should also be punishable by law. But this is so regardless of whether HIV transmission is involved. Being sexually assaulted and being infected with HIV, or any STI, and/or being made pregnant, is worse still. But transmission of HIV needn't be involved for non-concensual sex to be abhorred. And one can have a moral objection to non-concensual sex without that moral objection even being a religious conviction. It is, or should be, a crime, punishable by the law.

All this may seem obvious to some people. But other people's reaction to what they see as immoral behavior seems, to me at least, to be downright immoral. These people would justify sexual assault on the grounds that they were preventing the transmission of HIV. They made a young woman strip because she was 'dressed indecently' and 'in an alluring way with the intention of passing on the HIV virus'. I don’t think I need dwell further on how ludicrous this argument is. They didn't even know if the young woman was HIV positive, they just felt, by making her take off her clothes, that they were upholding morality. This may seem like an isolated incident but it has happened on other occasions and, according to onlookers, many people took photographs.

People can make up their own minds as to who was 'upholding morality' and who was doing the opposite. My intention is to raise the question of why HIV, a disease, has been turned into an excuse for discriminating against people, whether by ‘moral’ vigilantes or leaders in the HIV industry. Viruses are not moral entities, but people are. Why are people being punished because they have been infected by this particular virus? Because this particular virus is said to be a consequence of immoral behavior. In Africa, that immoral behavior takes the form of heterosexual sex.

Immoral behavior should be treated as societies see fit; but surely that doesn't involve those considered to be immoral being made the victims of equally immoral, criminal behavior? Punishing a person for having a virus will not do them, or anyone else, any good. And having the virus is not, in itself, immoral. Failing to tell your partner that you are HIV positive or deliberately spreading a virus is wrong. But deliberately harming someone in any way is wrong.

One of the few things that the HIV industry is right about is that people should know their HIV status. But what the industry doesn't seem to want people to establish is how they became infected. The industry only seems to want sexually active people to know their status. Yet many are infected with HIV but are not sexually active; or they are sexually active but were not infected sexually. Everyone needs to know how HIV is spread, whether they are HIV positive or HIV negative because everyone needs to know how to prevent the spread of the virus and to put themselves in a position to do so.

If people don't know how they became infected it will not be possible to eradicate HIV infection. Somehow, millions of Africans are HIV positive and millions more are destined to become infected and the HIV industry doesn't want to do anything about it. I can't say why a large group of well educated people are more interested in propping up their industry than establishing exactly how HIV is spreading in countries like Swaziland. All I know is that they want people to believe that HIV is almost all about sex in Africa.

Even where HIV is sexually transmitted, reducing transmission is not a simple matter of legislating about who can have sex, with whom, when, where and what forms that sexual interaction can take. That hasn't worked anywhere and will never work anywhere. People may well need education about sexual risk taking and the like. But they need education about all sorts of things. A few sex education programs that skate over anything important is not going make up for a lack of education. And programs that fail to mention non-sexual HIV transmission, through unsafe medical or cosmetic procedures, for example, will have little effect on any HIV epidemic in Africa.

By making people fear the stigma and discrimination associated with being HIV positive more than the virus itself, the HIV industry has ensured that many people will never want to know their status. And many who do know will not wish to find out how they became infected. But people really should know how they became infected; otherwise how will uninfected people know how to protect themselves?

The HIV industry simply assumes, and wants others to assume, that people became infected through unsafe sex, at least, if they are African. The most frightening thing about HIV is the refusal of the HIV industry to address HIV transmission in all its forms, how they don't seem interested in anything but sexual transmission, which they have been completely unable to influence in any way, how they appear happy to see HIV continue to spread while they work their way through obscene sums of money that could be used to eradicate the disease. HIV itself is amoral, but that kind of industry is run by people whose morality needs serious attention.

HIV is a virus. It is not a weapon or a punishment. Yet the HIV industry and various other parties use it as a stick to beat HIV positive and HIV negative people. Some beat women, some beat men, some beat Africans, men who have sex with men, commercial sex workers, intravenous drug users or anyone who can be deemed to be 'immoral' in some way. It's always someone else who spreads HIV and they are always bad people, according to the orthodox view. But viruses are spread by infected people. And you won't cure a virus with a stick.


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