Sunday, December 5, 2010

UNAIDS' Obsession with Sex Helps Spread HIV

According to an article in Tanzania's Citizen newspaper, there is 'growing concern' that HIV transmission is increasing among those in long term relationships and in marriages. Yet HIV prevalence has been high in these groups for a long time. Tanzania may not have carried out a Modes of Transmission Survey recently, as Kenya and Uganda have done. But the three countries have similar epidemics.

The advice that having sex with a long term partner or spouse will protect you from HIV has never been quite true. 'Safe' sex practices may include reducing the number of partners you have and various other measures, such as using condoms, avoiding sexually transmitted infections, etc. But HIV is not, and has never been, solely transmitted sexually. It is also transmitted through unsafe medical practices, such as unsterile injections, traditional medicine, cosmetic practices, such as shaving and tattooing and perhaps other means.

Telling people that they will be protected from HIV if they 'abstain' from sex or obey any of the other paternalistic strictures of the predominantly right wing 'Christian' prevention programs that dominate African country HIV strategies is extremely unethical. Since HIV was first identified, it was clear that it was mainly transmitted through contaminated blood. Sexual transmission was also recognised, especially through anal sex. But the risk of transmission through heterosexual sex was and is quite low.

People are entitled to know that if someone is HIV positive, this does not mean they are promiscuous. You can not tell how someone was infected with HIV without investigating, and even then, the exact cause may still remain unclear. It is worth bearing in mind that heterosexual sex is not an efficient transmitter of HIV. But contaminated blood is a very efficient transmitter.

Many people who are HIV positive are unaware of how they were infected and assume that because they are not virgins, they must have been infected sexually. However, they need to find out if their partner is infected. And even if their partner is infected, they may still not have been infected sexually. It's perfectly possible to be infected through unsafe injections, say, even though your partner was infected sexually.

It is vital that people are made aware of the risks they face and the steps they can take to reduce those risks. They need knowledge, skills and empowerment to be able to ask health and other professionals for evidence that they are observing all safety guidelines. This is necessary to ensure that neither HIV nor any other blood borne infections are transmitted during routine procedures. If people don't know about nosocomial HIV infection, infection through unsafe medical procedures, they will not be alert to the risks and will not take steps to avoid them.

It is heartening to hear that some have made the connection between exposure to contaminated blood and HIV transmission. A group in Kenya, and more recently in Tanzania, has recognised that HIV can be transmitted if care is not taken removing jiggers. This is often done using an unsterilized safety pin or other sharp object. If the object is then used on other people, there is a considerable risk of transmitting HIV and other viruses. Even if a virus is not transmitted, serious infections can result.

But despite small numbers of people in Kenya and Tanzania knowing that HIV is not just transmitted sexually, UNAIDS and others in the HIV industry are reluctant to accept the importance of non-sexual transmission. Official figures estimate that transmission through unsafe medical practices is very low. As a result, only a tiny fraction of the billions being ploughed into HIV prevention goes towards non-sexual HIV transmission.

Exactly why UNAIDS and the rest of the industry wish to ignore non-sexual HIV transmission is not clear. But the organization has always been pretty irrelevant to the HIV pandemic. With our without UNAIDS, people need to recognise the most common and the most serious risks they face. HIV is not just about sex and it has never been just about sex. Anything that involves exposure to blood or certain other bodily fluids can carry a risk of transmission of HIV and other viruses.

[For more about UNAIDS' and the HIV industry's obsession with sex, see my other blog.]



IRMA said...

The vast majority of HIV infections occur due to unproteced vaginal and anal intercourse. That is a fact. HIV is very much about sex.

The second biggest contributor to the epidemic is the use of contaminated syringes by injection drug users.

Simon said...

Thanks for your comment; you may have a point, you just don't cite any evidence or argument.

However, my point is that the majority of infections, according to the official figures, seem to occur as a result of ordinary heterosexual sex, not as a result of high risk sex. Yet, many people in every country in the world have unprotected heterosexual sex, just as much as people in high prevalence African countries do.

So why do some African countries have such high HIV prevalence? If, as you claim, HIV is very much about sex, why is prevalence less than 1% in many Western countries and 40% in parts of some African countries?