Monday, March 21, 2011

GPS Data Analysis Upholds Stork Theory of Where Babies Come From

A story is told about a grumpy conductor who said to a cellist (I'm paraphrasing): 'You have between your legs one of the most sensitive instruments known to man, and all you can do is scratch it'. The story comes to mind sometimes when reading the latest findings about HIV epidemics.

Many researchers come up with great data, data that should change the way that HIV prevention programs are targeted. A lot of recent data, and even some not so recent, clearly shows that HIV transmission is not nearly as closely related to sexual transmission as has been assumed so far. But this never seems to have any influence on prevention programs.

UNAIDS and the HIV industry in general take it as read that 80% of HIV transmission in African countries is a result of heterosexual sex. They claim that almost all of the remaining 20% is accounted for by mother to child transmission. This leaves very little for intravenous drug use, men who have sex with men and various forms of non-sexual transmission, such as unsafe healthcare.

A recent piece of research by Myong-Hyun Go, B Coburn, J Okano and S Blower uses GPS coordinates to depict HIV clusters or hot-spots in Lesotho. Lesotho has one some of the highest HIV prevalence figures in the world. They range from 8.5-46.6% for women and 4.1-39% for men.

Remarkably, the hot-spots for high female prevalence do not overlap with those for males very much. Those for females are mainly located in two lowland urban centres, the most heavily populated areas in the country. Those for males are mainly located in two less heavily populated mountainous areas, quite distant from the urban centres.

The research also finds that travel between most parts of Lesotho is not too efficient. Even travel between areas of high female prevalence and high male prevalence, according to the maps provided, could be quite challenging. These findings are referred to as 'spatial heterogeneity', which sounds rather quaint, under the circumstances.

Do most of the inhabitants of one of the poorest countries in the world expend most of their time and income on travelling to and from different parts of the country for the sole purpose of having sex, with as many different partners as possible, if official HIV lore is to be believed?

I think many people whose minds are relatively unbiased, especially by said official HIV lore, might question the 'behavioral paradigm', the view that almost all HIV is heterosexually transmitted in African countries. There must be something else to these incredible rates of transmission.

Not only must people be having immense numbers of sexual experiences, with immense numbers of people, but if the heterosexual sex theory is true, there must also be something else accounting for the increased susceptibility of this population.

After all, HIV prevalence among sex workers in India is only about 7% and the disease, according to the official story, is something of an occupational hazard for them. National prevalence in Kenya, Tanzania and Uganda is around 7% or less, which is itself shocking when compared to the figure for India.

But even if we embrace the extreme prejudices of UNAIDS and their accomplices, we must still wonder what it is about the Basotho people that accounts for almost unprecedented rates of transmission (and, of course, their superhuman feats of mobility and sexual prowess).

The researchers, however, don't even raise such questions. They merely conclude that prevention programs must be gender specific ones, such as circumcision for men and microbicides for women.

Even if it is true that most transmission is through heterosexual sex, these interventions will have only a relatively small impact, if any. Neither intervention has been shown to reduce transmission very much outside of some highly questionable trials.

But the data screams out for thorough investigation of how HIV could be transmitted heterosexually when so many HIV positive men and women live so far from each other. There is also an urgent need to find out if there is some additional factor that could explain how a virus that is difficult to transmit sexually affects such an enormous number of people. And it would be a further disgrace to the HIV industry if it just lets this data go by without it having any influence on global HIV prevention policy.


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