Thursday, September 8, 2011

Gender Sensitivity: Investigating Non-Sexual HIV Risks

Yet another article about the fact that far more women than men are infected with HIV in Kenya (as is the case in all African countries); this time, women account for 65% of all new infections. According to another document, "women aged 15-24 are four times more likely to be infected than men". Cue a collective wailing about 'gender mainstreaming' and other nebulous buzzwords.

But even taking the first figure, twice as many women are infected as men. So who is infecting them? Given probabilities such as one in 500 for transmission from men to women and one in 1000 from women to men, this would take an awful lot of 'unsafe' sex. And it would need to be spread over many years, whereas many females are being infected in their teens and twenties, when most of them would not have been sexually active for long.

Assuming that this is almost all a result of heterosexual sex, as the HIV industry does, would also suggest that women are far more sexually active than men, which is not the case according to research into sexual behavior. Not only do most men not frequently engage in 'unsafe' sex, but women do so even less frequently.

And for someone to be infected, whatever the probability of transmission, they must infected by someone who is HIV positive. But if most men are not HIV positive, we go back to the first question; who is doing all the infecting? In one part of Kenya, fewer than two men are infected for every 10 women.

Popular as it is to indulge in speculation about 'African' sexuality, how often 'they' have sex, what kinds of sex they have, how badly the women are treated and how bad the men are, much of what is written about such things is based on prejudice, not on the findings of valid research.

The fact is, no one has yet demonstrated how a virus that is difficult to transmit sexually has come to infect up to a quarter of the population in a few countries and half of all females in another few countries. Even less has anyone shown how a relatively small number of men managed to infect a large number of women, including women who have only had one, HIV negative partner.

So the Kenyan and other governments can write as many official documents as they like bemoaning HIV transmission figures, and calling as many of these documents as they like 'new', but none of them are new. Everything is done the same way as it has been done for years, despite this having no noticeable effect on the epidemic.

HIV is not just about sex. Authors of these documents may accept that but there is little substance behind their acceptance. HIV needs to be prevented, yet only an estimated 20% of HIV money goes to prevention, while nearly 60% goes into treatment and care. Much of that prevention funding goes to rather vague activities that relate to individual sexual behavior, activities that have been shown to be virtually useless.

Less than 3% of all funding goes towards ensuring that people have access to safe injections and other healthcare procedures. This is where all African strategic plans come apart (they are all very similar); they simply ignore non-sexually transmitted HIV. UNAIDS may deny it vehemently, but non-sexual HIV transmission contributes a lot more than the 2-2.5% that they claim for Kenya's epidemic. Even the WHO publicly accepts this.

Doing things differently means reducing the emphasis on sex when there is plenty of evidence for non-sexually transmitted HIV, among women whose only partner is HIV negative, infants whose mothers are HIV negative, virgins and people who have only had 'safe' sex. Recognizing the importance of gender means investigating the non-sexual risks that women face.

The most important type of gender sensitivity right now is to investigate the risks that women face and that men face less often, if at all. This should also reveal the risks that African women and men face, ones that non-Africans face less often. Sex may play a part in serious HIV epidemics, but not as big a part as in the collective fantasy that is the current HIV orthodoxy.


1 comment:

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