Thursday, December 1, 2011
A recently published survey shows that national HIV prevalence in South Africa has hovered at just under 30% since 2004. The authors suggest that a lot more people are living longer with HIV because they are accessing antiretroviral treatment. This may be so, but not many South Africans were accessing treatment until fairly recently. What the figures also suggest is that a few hundred thousand deaths every year are also being matched by a few hundred thousand new infections.
There's a massive variation between provinces, ranging from just over 20% in Kwa-ZuluNatal to 3% in Northern Cape. There's also a huge variation among age groups, with highest rates among 15-29 year olds, but peaking among 20-24 year olds at just over 30%. Still, the 19% prevalence figure is astonishing for 15-19 year olds and is in need of explanation.
From less than 1% in 1990, HIV prevalence has increased rapidly, exceeding 20% in 1998 and reaching 25% in 2001. Prevalence has not fallen below 25% in the last 10 years. Rates in antenatal clinics are even more astonishing, reaching over 40% among 30-34 year olds. The highest rate of all, 46.4%, was found in Uthukela, Kwa-ZuluNatal.
It's something of a conundrum that so many more women than men are infected in South Africa and other high HIV prevalence countries, all of which are in sub-Saharan Africa. It's a conundrum because hardly any women are infected in Western countries, compared to men. One of the few female risk groups in Western countries is intravenous drug users. Even sex workers are unlikely to be infected unless they are also drug users.
So why is it that the opposite is true in Africa? Western women are infected through heterosexual sex, but in very low numbers. Yet in South Africa, most of the women infected are not intravenous drug users or sex workers. According to the HIV orthodoxy, they are infected through heterosexual sex, apparently penile-vaginal sex.
And most Western men are infected through receptive anal intercourse or intravenous drug use. Some may be infected through heterosexual sex, but not many. Far more men than women are infected because far more men than women face the most serious risks.
Indeed, in African countries, it could be asked how many men are really infected by women through penile-vaginal sex. Because the lower percentage of men infected also includes those who engage in receptive anal sex and those who are infected through intravenous drug use. Few women engage in intravenous drug use, though they face the same elevated risk of infection through anal sex as men who engage in receptive anal sex.
It could make one wonder just how many men are being infected through heterosexual sex, and how so many women are being infected by what amounts to a relatively small number of HIV positive men. Of course, you can add in the HIV orthodoxy special African spice of dry sex, concurrency, rampant levels of partner change, etc. But you might still wonder...
Then there are, in the same report, the figures for syphilis. From a high of just over 11% in 1997, when HIV prevalence was just under 20%, syphilis fell steadily to a quarter or even a sixth of that rate after 2000, and stayed there. Syphilis rates do not correspond with HIV rates, not even a little bit. Kwa-Zulu Natal has the second lowest rates and Northern Cape has the highest. Also, syphilis prevalence does not vary much by age.
You might be forgiven for thinking that the virus that is difficult to transmit sexually, HIV, must also be transmitted non-sexually, perhaps to a very great extent, since the relatively easy to transmit syphilis dropped at the same time as HIV was increasing, and stayed low, while HIV stayed high. Or you might immediately dismiss that idea, since it flies in the face of so much UNAIDS propaganda.
Either way, you might wonder if the same virus, HIV, could only infect those who take the biggest risks in Western countries, yet it seems to infect more of those who take the smallest risks in African countries. Or you might be a member of the mainstream press, and not wonder at all, not once in thirty years.