Saturday, August 27, 2011
In a letter to The Lancet, Dr David Gisselquist raises a number of perfectly valid questions. There are millions of HIV positive women in Africa who have a HIV negative partner. How did these women become infected? The vast majority of these women have not had sex with anyone but their partner; and a substantial number of them have not had sex with anyone.
The issue Gisselquist is raising is not an entirely scientific one. The data available is clearly not sufficient to show how the women are becoming infected. So you have to make a choice between accepting that women who say they have only had one, or even zero partners, are telling the truth, or assuming that they are lying. If you choose the former, the question is pertinent.
But if you choose the latter, the women could have had any number of partners and any amounts of just about any style of sex imaginable, 'safe' and 'unsafe'. And this is exactly the way the HIV industry looks at HIV in non-Western countries, especially African countries.
This is the typical, highly racist view that most Africans, especially African women, are liars. In addition, they are unbelievably promiscuous and will sleep with just about anyone for money, gifts, status or whatever else happens to be rumoured at a given time. There is nothing scientific about assuming the women are lying or about making up a story to fit the data.
Gisselquist urges us to consider the possibility that Africans are not all dishonest, promiscuous, feckless, without a care for their own health, that or their partner or that of their children and other dependents.
When a HIV positive women has to reveal her status to her HIV negative partner and the entire HIV industry is telling him and everyone else that 80-90% of HIV is transmitted through heterosexual sex in African countries, what are her chances of being believed when she says she has not been having sex with someone else?
But the pointy-hatted brigade have published a 'reply' to Gisselquist's letter, signed by Edward J Mills and Nathan Ford. They start off by accusing those who say we have given far too little attention to non-sexual HIV transmission of having "an insufficient understanding of basic epidemiological principles".
But this is not about epidemiology when it comes down to it. Mills and Ford simply deny the possibility of non-sexual transmission playing a role, or even a partial role, in the massive HIV epidemics found in some African countries. And they make the astounding claim that "several epidemiological models have shown that an unfeasibly high number of unsafe injections would be needed to account for the HIV epidemic".
So instead of an unfeasibly high number of unsafe injections (and various other non-sexual risks that Mills and Ford completely ignore), they posit an unfeasibly high number of sexual exposures. The transmission probability for most kinds of non-sexual exposure is many times higher than that for most kinds of sexual exposure.
You don't need evidence to demonstrate that Africans do not engage in unfeasibly high levels of unsafe sex; the levels posited by various mathematical models and vague theories are just that: unfeasible.
And it's important to note that Gisselquist is not claiming that "men acquire HIV/AIDS through sex but women do not", as Mills and Ford state. He accepts that men and women acquire HIV through sex, sometimes. But far too little investigation has been carried out in high prevalence countries to rule out high levels of non-sexual transmission, probably through very common health procedures, such as hormonal birth control injections.
Far more women are infected with HIV than men in high prevalence African countries. And women often face far more non-sexual risks than men. This should trigger some careful investigations. Instead, it triggers a lot of frothing at the mouth about "diverting of attention" from what Mills, Ford and the rest of the HIV industry consider to be obvious: that Africans are just different, not entirely human, very stupid, selfish and careless.
HIV Scientists' main stumbling block seems to be in seeing themselves as veterinarians when they deal with Africans. If they ask people questions, they need to have the integrity to believe the answers they get. And if they wish to base their HIV prevention strategies on racist assumptions rather than on their own evidence, they should learn to distinguish between science and prejudice. These are not fine distinctions, by any means, but they are vital.