The Nairobi Star has just noticed that HIV prevalence is far higher among employed people than unemployed people, according to the Demographic and Health Survey, 2008-09. They don't cite the correct figures (see graph for corrected figures), but this is not a new trend. So why would employed people be more likely to be infected? According to the Star, it's because they have "disposable incomes which provide the ability to support multiple sex partners and even buy sex, living away from spouses because of employment, drug and alcohol use and abuse of recreation" [sic].
If the author is right, and she certainly holds the orthodox view, then women must be buying a lot of sex too, perhaps more than men. But the same survey also shows that levels of 'unsafe' sexual behavior are far higher among men than women. Men are also more likely to abuse drugs and alcohol. Yet HIV prevalence is consistently higher among women. Prevalence is also higher among people with more education, people with more money (whether employed or not) and people in urban, as opposed to rural areas.
Tempting as it must be for a journalist to present sex as the 'obvious' answer to higher HIV prevalence among employed people, perhaps they should look at another possibility, the possibility that sex is not responsible for all HIV transmission. Most HIV transmission in Kenya (Uganda and Tanzania) occurs between people who do not take many risks under the orthodox criteria for risky sex. HIV prevalence patterns do not seem to relate to sexual behavior patterns.
Maybe journalists would like to look at another scenario: employed people, better educated people, wealthier people and urban dwelling people have greater access to health and cosmetic facilities, where conditions may not be very safe. UNAIDS believes that their own employees need to take care in health facilities that have not been approved by the UN. But will they ever get around to warning Africans?
[For more about non-sexual transmission of HIV through unsafe healthcare and cosmetic services, see the Don't Get Stuck With HIV site and blog.]