Tuesday, March 1, 2011

Institutional Sexism and Racism Driving African HIV Epidemics

If you were to consider just two aspects of HIV transmission, firstly, that it is not easily transmitted through heterosexual sex and secondly, that it is easily transmitted by certain non-sexual routes, you might come up with a proto-hypothesis that high prevalence epidemics found in some African countries are not primarily driven by heterosexual sex.

I say 'might' because the HIV industry concludes from the fact that HIV is not easily transmitted through heterosexual sex, that Africans must have extraordinary amounts of sex. Evidence suggests that Africans don't have extraordinary amounts of sex, so the industry further concludes that almost all the sex Africans have is 'unsafe'.

Research has also makes it clear that only some people have a lot of sex, although quite a few Africans (and non-Africans) are reluctant to take precautions and engage in what is considered to be safe sex much of the time. But the majority of Africans, like the majority of non-Africans, just have ordinary amounts of sex, safe or otherwise.

More worryingly, 'safe' sex practices, such as later sexual debut, fewer partners, greater condom use, etc, are often correlated with similar and even higher rates of HIV transmission. Yet still, the HIV industry doesn't conclude that they should put aside their obsession with the sex lives of others and re-examine non-sexual modes of transmission.

Over the years, the industry has come up with one 'explanation' after another as to why very high heterosexual HIV transmission rates are only found in some countries and some parts of some countries, and they are all in Africa. Multiple partnerships was eventually shown not to explain high transmission rates so the concept of concurrency was added in.

But like sex and unsafe sex, evidence showed that only some people engage in concurrent partnerships, sexual partnerships that overlap. Most people don't engage in such partnerships. Also, concurrent partnerships are not exclusive to Africans. They occur everywhere, but without the massive rates of HIV transmission found in some African countries.

It didn't take HIV researchers long to compound the racism of their account of African sexuality with the racist assumption that Africans generally lie about their sexual behavior. Well, some do, as do some non-Africans. But anything that fails to fit the HIV industry picture of African sexuality is discounted as lies.

And the institutional racism itself is compounded by a form of institutional sexism. Women, under the orthodox model, appear to lie a lot more than men. We are told that, not only are they far more promiscuous than men, but they admit to far less promiscuity. The industry 'knows' that they are lying because HIV rates are far higher among women than an assumed greater susceptability could account for.

Few may be surprised to hear that academics, political and religious leaders, professionals of all kinds, journalists and many others are deeply racist and sexist. But I think it would come as a surprise to many to hear  that the heterosexual HIV pandemic in African countries is driven by these prejudices.

If Africans don't have the extraordinary sex lives that only exist in the minds of those who should be able to see prejudice for what it is and women in developing countries are not highly promiscuous, callous, uncaring and careless about their lives and the lives of others, we have to look elsewhere for an answer to the oft repeated question: why is HIV transmission so different in a handful of African countries?

It is not for lack of evidence that the entire HIV industry still assumes that HIV is predominantly driven by heterosexual sex in African countries (though, unintuitively, not in non-African countries); the assumption is underpinned by these prejudices. There is nothing else supporting the assumption. There is ample evidence showing that the assumption is contradicted by everything we know, or should know.

Clearly it needs repeating: HIV is also transmitted non-sexuall, through unsafe healthcare, unsafe cosmetic practices and perhaps through other routes. Until these modes of transmission have been adequately quantified, it will not be known whether they play a greater or lesser part in HIV transmission than heterosexual sex. But we will have little impact on HIV transmission until we are clear where the majority of infections are coming from.

UNAIDS and the HIV industry don't like people to mention non-sexually transmitted HIV. That's fine, we can stop talking about once it has been investigated properly. But unless there is some mystery mode of transmission that has remained undiscovered up to now, we can't continue to pretend that it is all heterosexually transmitted in Africa when we know that's not true. There may be billions of dollars invested in sexually transmitted HIV, along with the reputations of a lot of institutions and people. Perhaps the ones who embrace the truth will gain first mover advantage.


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