Tuesday, June 21, 2011

HIV Can Be Spread in Beauty Salons, Despite UNAIDS Denial

An article about beauty salons in Georgia (the country, not the US state) makes it clear that HIV, hepatitis B and C and other serious viruses can be spread when good hygiene measures are not observed. Many salons, we are told, do not meet adequate standards. Customers are more interested in getting a good price than in avoiding health risks.

Perhaps people are not even aware of the risks, though. The article didn't manage to find any cases where serious infection had been confirmed to have come from a beauty salon. But if few people know about the risks, they are not likely to connect their infection with a visit to a beauty salon, which may have taken place years, or even decades before.

Even health professionals are unlikely to make the connection. When a HIV positive patient visits a health facility in most countries (I don't know if it's the same with Georgia), they are far more likely to be asked about their sexual history, with other risks given less attention, if any.

Adequate sterilization of instruments that may break the skin requires expensive equipment and good training and management. These may be absent in some salons. And all sorts of treatment can carry risks, not just manicure and pedicure but also male and female hairdressing, shaving and body piercing.

With a population of 10 times that of Georgia and a GDP per capita of less than one tenth, Tanzania must be in a far more dangerous position. There are many salons here, but price is even more important than it would be in a relatively rich and far more developed country.

In fact, the majority of poorer people in Tanzania do not go to salons for a lot of cosmetic work. The needs of many are attended to by friends and family with little or no training and even less access to sterilization equipment. Others go to the ubiquitous street cosmeticians, who will do your hands and feet out in the open as you wait for your bus or your friends or whatever.

UNAIDS doesn't even consider non-sexual transmission to be an issue when it comes to HIV in high prevalence countries. They insist that only around 2-2.5% of transmission occurs in health facilities. No mention at all is made of cosmetic or other non-sexual risks in the Modes of Transmission Surveys that I have seen for African countries.

It would be odd indeed if a country like Georgia were to be a risky place for such non-sexual transmission and a country like Tanzania (or Kenya, Uganda, South Africa, Swaziland and other high prevalence countries) were to be risk free. If people face sexual risks, they probably also face non-sexual risks. And that means they need to be made aware of these risks.

Non-sexual risks are recognised in some countries. A recent paper on the subject of hepatitis B in Pakistan notes "Lack of awareness, socioecomic conditions, sexual activities and sharing of razor blades, syringes and tattooing needles" as risk factors. And there, 21% of the population are infected with hepatitis B. Therefore, non-sexual risks in high prevalence countries need to be given as much attention as sexual risks.

[I should have mentioned that the Pakistan study is about Internally Displaced Persons (IDP), a group that is not representative of the population as a whole. National hepatitis B prevalence is estimated at about 67.5%, far higher than in the study population. In African refugee and IDP camps, HIV prevalence is usually significantly lower than in the population as a whole. Risks are clearly lower, although these camps are said to involve many hazards.]

Any exposure to blood, pus and other bodily fluids could carry the risk of serious disease transmission, especially where viruses like HIV and hepatitis are endemic. Teaching people only about sexual risks when serious non-sexual risks are being faced by everyone in a population, sexually active and non-sexually active people alike, is allowing some of the most easily prevented instances to continue, uninvestigated and unhindered.

UNAIDS have a standard excuse when non-sexual transmission is mentioned. They feel that it could deflect attention from sexual transmission. But if people face both sexual and non-sexual risks, UNAIDS are failing in their duty to give people accurate information that could protect them and their children. We will not protect people from HIV by lying to them about the risks they face.



Joyful said...

Hi Simon, this is very important information. Thanks for sharing it.

Simon said...

Hi Joyful. You're right, it's very important. I just hope that UNAIDS will start to ask how important it is, as the whole issue receives very little attention.