Even Sex Tourists Are Susceptible to Non-Sexually Transmitted HIV

Not that all British people contracting HIV abroad are sex tourists, but you might think that sometimes. The British HIV Association's HIV Medicine has a brief article about HIV infections contracted by British people when abroad. 2066 out of 13,891 (15%) are said to have been so acquired between 2002 and 2010. While only 22% of HIV infections in the UK are said to be a result of heterosexual sex, the figure is estimated to be 70% for those who acquire the virus abroad. Oddly, the article doesn't mention non-sexually transmitted infections. While these may not be so common in the US, where a sizable number of the infections may have been contracted, they could well be common in Thailand and South Africa, which are also said to the source country for many of the infections (particularly Thailand).

The article makes the following recommendation: "[That] HIV prevention and testing efforts be extended to include travelers abroad, and that sexual health advice be provided routinely in travel health consultations and in occupational health travel advice packs, particularly to those traveling to high HIV prevalence areas and destinations for sex tourism. Safer sex messages should include an awareness of the potential detrimental health and social impacts of the sex industry."

This could be compared with the advice found in the Lonely Planet travel guide - East Africa, 5th Edition: "Any exposure to blood, blood products or body fluids may put the individual at risk [of HIV infection]. The disease is often transmitted through sexual contact or dirty needles - vaccinations, acupuncture, tattooing and body piercing can be potentially as dangerous as intravenous drug use. HIV/AIDS can also be spread through infected blood transfusions; some developing countries cannot afford to screen blood used for transfusions. If you do need an injection, ask to see the syringe unwrapped in front of you. Fear of HIV infection should never preclude treatment for more serious medical conditions."

Personally, I'd prefer the latter advice. If HIV experts are not prepared to discuss non-sexual risks, people might be better off turning to popular travel guides, which tend to give the sort of advice also given to UN employees working and traveling in developing countries:  “In several regions, unsafe blood collection and transfusion practices and the use of contaminated syringes account for a notable share of new infections.” But, “[b]ecause we are UN employees, we and our families are able to receive medical services in safe healthcare settings, where only sterile syringes and medical equipment are used, eliminating any risk to you of HIV transmission as a result of health care.” WHO also advises those who are not able to access an approved clinic: “Avoid any procedures that pierce the skin, such as acupuncture and dental work, unless they are genuinely necessary. Before submitting to any treatment that may give an entry point to HIV, ask whether the instruments to be used have been properly sterilized.”

The only problem is that UNAIDS, WHO and others don't extend the above advice to Africans; the British HIV Association seem to be following their example in not extending it to British people traveling abroad. It's quite possible that the British people who are said to have acquired HIV abroad really did have unprotected sex, as the article claims. But it is also possible that some of them received medical treatment, possibly for a sexually transmitted infection, possibly in the kind of conditions that UN employees (but not Africans) are advised to avoid. 9% of the females infected abroad were thought to have been infected in Kenya and nearly 8% in South Africa. Infections probably acquired in Nigeria and Zimbabwe were also reported. If health facilities are risky for UN employees they are also risky for Africans, and even for visiting British people.


[For more information about non-sexually transmitted HIV from unsafe health and cosmetic practices, visit the Don't Get Stuck With HIV site and blog.]