Beware of Reassurances About Genetically Modified Organisms

In what may be an attempt to reassure the public, an article in Tanzania's Daily News says "Only South Africa and Egypt have potential to handle cultivation and consumption of genetically modified organisms (GMO) [in Africa]". But this message comes from Dr Tesfai Tecle, a spokesman for the Alliance for a Green Revolution in Africa's (AGRA) Kofi Annan.

Another of AGRA's token Africans, Dr Namanga Ngongi, goes further and says that GMOs are too complicated and sophisticated for countries like Tanzania to adopt. Tecle claims that AGRA's position is clear, that they "don't support genetically engineered seeds".

But this does not fully characterize AGRA's position on GMO because their own website says they "do not preclude future funding for genetic engineering as an approach to crop variety improvement when it is the most appropriate tool to address an important need of small-scale farmers and when it is consistent with government policy".

AGRA is the joint spawn of the Gates Foundation and the Rockefeller Foundation, neither of which are in any way averse to GMOs. The former has invested millions in Monsanto and the latter, despite making some claims to be sceptical at one time and funding some 'research' into the subject, are 100% behind GMOs.

Proponents of GMOs often talk about 'feeding the world' and 'food security', yet these two particular proponents are also very keen eugenicists. They are particularly in favor of people in developing countries having fewer children, since to their institutions, development means little more than population control.

So, there is no contradiction between between supporting GMOs and being a eugenicist, despite the fact that successful eugenics would lead to fewer mouths to feed. Because GMOs are, ultimately, for those who can afford them. Whether they are paid for by public or private money is immaterial. The claim that GMOs can actually play a part in improving the lives of the poor is just a popular myth used by the industry.

The advantage of GMOs is not that they are cheaper, they are not. Yields are not better. They cannot, despite the publicity material, grow in sup-optimum conditions, they are not more nutritious, they do not have special qualities, such as drought or salinity resistance, or anything else.

The sole advantage is that they are owned by a handful of the world's most powerful food multinationals. If the world's seeds, or as many of them as possible, could be replaced by GMOs, these multinationals would control the world's food supply. Proponents of GMOs may mention small-scale farmers, the poor and starving, Africans and what not, but GM seeds are not owned by any of these groups and they never will be.

Which leads to another reassuring story that doesn't seem so reassuring when you look at it closely, the US Government's Feed the Future program, about to decend on Tanzania. The literature is too polite to mention GMOs but wait till you see the list of private partners:

Archer Daniels Midland, BASF (Zyklon-B), Bunge Limited, Cargill, Coca-Cola, DuPont, General Mills, Kraft Foods, Metro AG, Monsanto Company (Agent Orange), Nestle (Baby Milk), PepsiCo, SABMiller, Syngenta, Unilever, Wal-Mart, and Yara International.

This is not a list of the world's best known bleeding-hearts. And in among the bloodless hearts, in addition to its large investment in Monsanto, the Gates Foundation can be found listed as a donor and AGRA gets a few honorable mentions. Reassurances that GMOs will not be unleashed on unsuspecting and defenceless developing countries should be interpreted to mean something quite contrary to what they say.

Why is HIV Prevalence Higher Close to Health Facilities?

Caryl Feldacker, Susan Ennett and Ilene Speizer have published an article entitled "It's not just who you are but where you live: an exploration of community influences on individual HIV status in rural Malawi". Differences between urban and rural HIV rates have always been striking and have often seemed counterintuitive.

For example, people in rural areas often have less access to health facilities due to distance, cost and poor infrastructure. Yet HIV rates are almost always noticeably higher in urban areas, where infrastructure is better, there are more health facilities and people are wealthier.

This has been seen as an anomaly because poverty and accessible health services are usually associated with better health. Yet, the phenomenon is common. In Kenya, the province with least access to health, North Eastern, has by far the lowest HIV prevalence.

North Eastern also has other conditions which are sometimes associated with high HIV rates, such as low age of sexual debut, especially for females, high rates of female genital mutilation, high rates of intergenerational marriage (where the man is significantly older than the woman), low rates of condom use and high birth rates.

Several years ago, it was noted that HIV rates decline as you move from roads and urban areas in Tanzania, although the virus was becoming more common in rural areas and declining slowly in urban areas. So similar findings in Malawi are hardly a bolt from the blue.

But these researchers find that the closer you are to a health facility, the more likely you are to be infected. Those further away are less likely to be infected. In addition to highlighting the significance of non-individual possible factors in the transmission of HIV, they find that individual behavior is not nearly as significant as UNAIDS and the HIV industry insist.

Alas, what the researchers find, they try to explain away. They cite David Gisselquist and others who suggest that proximity to health facilities may increase the risk of HIV transmission because of unsafe medical practices. But the researchers speculate that a more plausible explanation is that proximity to health facilities happens to correlate with areas where risky sexual behavior is more common.

They claim this sexual behavior explanation is more 'plausible'. Well, it is if you accept that HIV transmission is almost all explained by reference to sexual behavior. These researchers show clear signs of being bitten by their own behavioral paradigm. They were not expecting to find such a clear indication that health facilities might actually be part of the problem.

So they deny it. Rather than accepting Gisselquist and co's explanation, which is compatible with their own somewhat futile specualations, they simply reject anything that threatens the paradigm. They have gone so far and no further. It's such a pity to see good research being used to prop up a crumbling theory, especially given the influence of that theory on global HIV policy.

One of the things the researchers say is particularly hard to fathom. They hypothesize "those with greater access to roads and cities, will be more likely to engage in HIV risk behaviors, and therefore, more likely to be HIV infected. Persons with greater access to health facilities will be less likely to engage in HIV risk behaviors and, therefore, less likely to be infected with HIV."

The first part of the claim has been one of the biggest failures of orthodox HIV transmission theory. There is no evidence that levels of risky sexual behavior are higher where HIV rates are higher. And there is no evidence that levels of risky sexual behavior are higher in high HIV prevalence African countries than low prevalence African and non-African countries.

And why would people with access to health facilities be less likely to engage in risky sex? Their rejection of Gisselquist and Co's theory even requires that they reject this hypothesis.

In fact, those who have greater access to roads and cities are, more or less, the same people who have greater access to health facilities. But there is nothing about health facilities themselves that results in lower levels of risky behavior (or higher levels, for that matter). There may be a bit of wishful thinking involved here, but otherwise it's a strange hypothesis.

It remains to be seen whether other researchers accept Feldaker and Co's analysis, which has the sole advantage of not threatening the mainstream. But others may begin to wonder if the possibility of non-sexual transmission, health care related transmission in particular, should be reconsidered in the light of this and other evidence. HIV prevalence may be higher close to health facilities for all sorts of reasons, but it's time to find out if health facilities are transmitting more HIV than UNAIDS has been telling us.

[Read about pre-exposure prophylaxis (PrEP) and health priorities on my other blog.]

Increase Testing, Find Out What is Really Driving HIV Epidemic in South Africa

There is a debate in South Africa about whether schoolchildren from 13 up should be tested for HIV. Some are opposed to testing, apparently claiming that children "may not be psychologically prepared to deal with a positive result or the stigma likely to follow". But the point of pre- and post-test counselling is to psychologically prepare people for getting the test and finding out the result.

This may be more difficult in the case of younger children. But that doesn't make it any less necessary. The alternative is to wait until symptoms appear, by which time treatment will be more difficult and the risk of serious illness and even death are increased. If found to be HIV positive, people can be monitored and treated as and when treatment is required.

South African health services may not have the capacity to treat all those who are in need of treatment. But they need to test as many people as possible to assess what exactly their needs are. Even if they can't give everyone the level of treatment they require, those who are not tested won't get any treatment at all.

The fact that, as one teachers' union representative points out, even parents are afraid to be tested, is not a reason for not trying to increase the numbers of people being tested. People have been filled with notions about HIV in Africa being transmitted almost exclusively by promiscuous behavior, which means that HIV is still highly stigmatized, even after thirty years of research showing that it is not solely spread sexually and it is not primarily a matter of individual responsibility.

But teachers, teachers' unions and others should be aiming to reduce stigma, not accepting it as inevitable. They may be correct in claiming that the government is trying to make up the numbers for their exaggerated claims about how many people they were going to test in a short space of time. Certainly, testing large numbers of children, who may be seen as easy targets, is a very cynical way of achieving projected figures.

However, countries with high HIV prevalence need to test more people, especially younger people. There are three reasons, the first being that people have better health outcomes if the disease is caught early.

The second is that testing early should help to work out how people are being infected. For example, some will have been infected by their mother, some will be sexually active and some will not fall into either of these groups. People who are neither sexually active nor infected since birth will need to be investigated carefully to find out exactly how they are being infected.

Nosocomial infection is very likely to be responsible in many instances. Failing to identify such sources of new infection and failing to do anything about them will result in continuing high rates of HIV transmission in South Africa and other countries where similar failures occur.

The third reason for testing as many people as possible is that HIV prevalence among young people is a useful proxy for HIV incidence, the yearly rate of new infections. Incidence is very hard to measure but without such measurements, it is difficult to predict how the epidemic is going, whether it is increasing or reducing.

Being able to treat infected people is only one good reason to test as many as possible. Finding out what is driving the epidemic is, arguably, even more important. Far more people are at risk of becoming infected than are already infected. One of the aims of HIV policy in South Africa needs to be to prevent new HIV infections, not just to passively identify those already infected so they can be treated accordingly.

Young people, especially young girls, are those most at risk of being infected with HIV. That harsh reality is a lot better than the reality of being HIV positive. If people are still afraid to be tested then the South African Government needs to challenge global HIV policy, which denies that a significant amount of HIV transmission could be non-sexual. If South Africa, with the largest HIV positive population in the world, is not prepared to stand up to this erroneous claim, who will be?

Unfortunately, a lot of young people will be identified as HIV positive even though they have never had sex. And they will not all have been infected by their mother, who may not herself be infected. Not all HIV positive young South Africans are being infected sexually so it needs to be made clear how they are being infected. Only then can the South African epidemic be successfully tackled. The less involvement from UNAIDS and the HIV industry, the better.

Sexual Behavior: Myth Supports the Assumption, Evidence Does Not

IRIN has a recent article entitled "Fidelity campaigns could take years to see results". This is not news. Campaigns advocating abstinence, limiting sex to one partner and using condoms have been around for years and it is well known that they take years to show any results. It is also well known that they don't have very much effect on HIV prevalence.

Despite this, much of the money spent on HIV prevention, a very small amount compared to that spent on treatment and care, is used for fidelity campaigns of one kind or another. They usually result people in being able to trot out the right answers to questions, which keeps the market researchers happy. And, in the end, these campaigns are a good way of spending lots of money.

Various institutions that have bought into these empty campaigns are very well funded and can afford good marketing. They are hardly going to produce reports showing that their campaigns were pretty pointless. Rather, they will put a gloss on everything so that they can continue to receive funding. That's often what the funders want, too.

Institutions such as PSI, that were set up to interfere in the sexual and reproductive health of people in developing countries, can be expected to spend their enormous budgets on their traditional interests of population control (or 'eugenics', as it used to be called). But they really don't need to react with such surprise when their campaigns continue to fail to make much impression on HIV transmission rates.

Whatever the claims of PSI and similar institutions, fidelity and other behavior change approaches to HIV prevention are constantly referred to as 'evidence-based', as if that vouched for their effectiveness. But the notion that "over 90% of adult HIV infections in sub-Saharan Africa are acquired through sexual contact" is an article of faith in the HIV industry, even though the dubious claim dates back almost 20 years.

An article published in BioMed Central, by Marshall Munjoma, et al, simply assumes the truth of this 'behavioral paradigm', assumes that Africans lead incredibly active sex lives, care little about their health, the health of their children or the health of their partners, and takes things from there. And yet, the article strongly suggests that not all HIV is transmitted sexually.

These researchers start by pointing out that HIV incidence, the yearly rate of new infections, peaked in the late 1980s and declined thereafter. They don't explain the initial spread of HIV, the peak in incidence, nor its subsequent decline. And they certainly don't relate these phenomena to sexual behavior.

Yet, if the sexual behavior theory of HIV transmission is true, the major changes in behavior must have begun in the 1980s. By the end of the 1990s, most people who were infected in the 80s would have died and those infected in the 90s would have continuted to die into the 2000s. Once incidence peaked and declined, little further behavior change is required to explain what happened since the late 1990s.

Not only do the researchers fail to explain the sexual behavior changes that must have begun in the 80s and continued through the 90s but they attribute the rapid declines in prevalence in the late 1990s and early 2000s to changes in sexual behavior! The decline in prevalence is due to high death rates. High death rates continue to reduce prevalence in Zimbabwe and new infections also continue, just at far lower rates than in the 1980s.

The researchers note that new infections among women attending ante-natal clinics women are very high over a 6 year period in the 2000s. But many of these infections probably occurred during the women's third trimester or not long after giving birth. Why is it assumed that they must have been infected sexually? Some of these women were probably not having sex very much at these times. Were their partners tested?

The study also found that half those infected were 20 years or younger and nearly 100% of married women reported having sex with their spouses only. The researchers seem content to ignore the possibility of non-sexual transmission in at least some of the people they spent so long tracking. What is the point of research that ignores such vital clues as to how HIV may be transmitted?

To tie in with the IRIN article and the blind faith in behavior change interventions, the authors conclude that the decline in prevalence is due to behavior change, even though 90% of the study participants, both those who seroconverted and those who didn't, do not believe that abstinence protects against HIV. If people don't believe abstinence will protect them, why would they abstain?

Why is HIV Prevalence So Low in Cuba? (Hint: Health Services)

Last October Esther Murugi, Kenyan minister for special programs, called for greater acceptance of gay people in society. Her call was met with predictable righteous indignation from most politicians and church leaders. And her call stirred up a bit of debate, a small amount of which may have been constructive.

In the last few days, Murugi called for isolation of HIV positive people as a means of eradicating the disease. Does she mean Kenya should isolate all 1.5 million HIV positive people for up to ten years and longer? Isolate them where? There are not enough schools for all the country's children nor hospitals for the country's sick people.

I'm inclined to give Murugi the benefit of the doubt. After all, she is willing to stand up for one of the most reviled groups in East Africa, gay people. And I don't think she can be held responsible for believing rubbish about HIV, given that global HIV policy is governed by a bunch of racist, sexist quacks.

Ok, she thinks that Cuba has one of the best controlled HIV epidemics in the world because they isolated HIV positive people. What she is probably not aware of is that Cuba has the highest number of doctors per head of population in the world. HIV positive people were actually treated, counseled and supported in Cuba, long before they were in most other countries.

Cuba, like many other countries (the US only recently dropped its travel ban on HIV positive people), panicked a bit at first. But they had one thing that most Western countries have and most African countries do not: good health services. And they took action to make sure that HIV transmission was reduced, both sexual and non-sexual transmission.

Murugi may also be confused because at one time Cuba didn't have access to antiretroviral drugs. That was because of US trade sanctions, not because those cruel Cuban leaders didn't care about HIV positive people. In fact, Cuba is probably one of the few countries in the world that acted decisively, quickly and effectively to limit the damage that HIV caused in most other countries, rich and poor.

Indeed, Cuba still manages to keep HIV transmission low, which is more than can be said for several Western, Eastern European, Asian, African and other countries. Cuba is fortunate in enjoying relative autonomy from UNAIDS and other institutions that seem to exert such a negative influence on HIV prevention and treatment policies around the world.

The minister is seriously misinformed, but misinformation about HIV is not uncommon, rather, it's the norm. And if any Kenyans happen to agree with Murugi, the answer is no, it's not going to happen. The country hasn't even tested the majority of HIV positive people yet or got the majority of people who need antiretroviral drugs on treatment. The country's health services do not have the capacity to even account for all HIV positive people, let alone isolate them, in any sense of the word.

If the minister wishes to make herself useful, she could raise the issue of gays again and perhaps take other measures to reduce HIV related stigma, rather than increase it. For instance, she could point to the evidence from WHO that a significant percentage of HIV comes from unsterile injections (and probably from other unsafe medical procedures).

The extremely low levels of HIV transmission in Cuba, from before HIV was identified, through the earliest days of the pandemic, right up to the present, probably have a lot more to do with the quality of their health services than with the amount of sex Cubans have or the types sexual practices most commonly found there. Levels of transmission in every country probably relates to quality of and access to health services and certainly doesn't relate to sexual behavior. But only Cuba seems to have noticed that.

And if Minister Murugi wants more Kenyan people to be tested, more HIV positive people to receive treatment and more HIV negative people to be protected, she needs to ensure than health services are cleaned up first. The last thing Kenya needs is for everyone to rush to their collapsing health services in the state they are in right now. That's only likely to increase transmission.

African Heterosexual Females Branded By Global HIV Policy

The murdered Ugandan gay activist, David Kato, was one of the victims of a piece of persecution by a tabloid newspaper, Rolling Stone. Rolling Stone published the names and photographs of people they believed to be gay. By the time a judge got around stopping publication the damage had been done.

I can't prove that David Kato was murdered because he had been exposed, I can't even prove he was murdered. But his death illustrates the sort of thing that can happen in a country where persecution of certain people is not considered important enough by the state to give them the protection they need.

The sort of hate and prejudice that lies behind the murder of David Kato exists everywhere, but some countries have laws to protect people from its worst excesses. Most gays can probably remain anomalous, or hope to. But they will all live in fear of discovery. If discovered, they could become victims of police violence, mob violence, persecution, extortion and the like.

But gays are just one group that suffers the consequences of hatred and prejudice. In some African countries, women are equally stigmatized. They can also be victims of violence and suffer injury, persecution and even death because they are a member of a stigmatized group.

Not all women are stigmatized to the same extent. But most victims of sexual and non-sexual violence are women. And the law in many countries gives them little protection, especially if the perpetrator of the violence is their husband or another family member.

In most countries, women are more likely to be poorer than men, live in worse conditions, play the biggest part in raising children, have lower levels of education, have less access to health and other social services and the list goes on. This is a result of prejudice, but of course, this is not the same kind of prejudice experienced by gays.

Women start to experience the kind of prejudice experienced by gays when high HIV prevalence is added into the picture. Fingers are pointed at sex workers and other groups. But in countries where HIV prevalence is highest among ordinary married women who only have one sexual partner, Uganda being a case in point, all women are branded as promiscuous.

Men are also branded as promiscuous, but HIV rates are far lower among men. Even people who just read what appears in the mainstream press suspect they are being lied to when they are told that it's men who go around spreading HIV and yet far more women are infected.

I often ask people for their opinion on how HIV is spread and if they think it's odd that in some places, HIV positive women can outnumber HIV positive men by 5 to one. They sometimes come up with the ludicrous suggestion that there is a small number of men who are responsible for infecting huge numbers of women. They must be very busy and such a group has never been identified.

Not for want of trying. Fingers have been pointed at 'mobile' people, either internal or external migrants, long distance drivers, armies and many other groups. But in the end, the majority of people being infected with HIV are ordinary people with ordinary sex lives. What UNAIDS refers to as 'low-risk' sex is, in fact, very high risk. I think of this as the UNAIDS paradox.

There is no paradox if you bear in mind that not all HIV is transmitted sexually, that some, perhaps a lot, is transmitted through unsafe healthcare and cosmetic practices. Most people are aware of these phenomena but there is a great reluctance to investigate. People prefer to say 'well, you're right, but I still think it's mostly sexually transmitted', or worse.

So I am not arguing that people who are HIV positive, whether they are gay, involved in sex work, injecting illegal drugs or anything else, shouldn't be stigmatized because stigmatizing people is wrong. It is wrong. But HIV positive people shouldn't be stigmatized because we don't know how they became infected. And even if they were infected sexually, that doesn't mean they have done anything wrong.

Anti-gay and other prejudices are not new and they are proving hard to reduce. But Africa suffers from an anti-African prejudice, based on the UNAIDS lie that 90% or more HIV in African countries is transmitted sexually. Effectively, heterosexuals and those who engage in heterosexual sex are the victims of prejudice and stigma.

If anti-gay stigma reduces the number of gay people who take precautions against infection with HIV, anti-African, anti-woman and anti-heterosexual stigma does the same. Few people want to be tested for HIV unless they have to because merely raising the possibility that you are infected invites suspicion, finger-pointing, ostracization, persecution and physical violence.

Like HIV itself, stigma doesn't just arise from 'somewhere else', from foreigners, migrants, Africans, women, right wingers, Muslims, or whatever. Stigma, HIV related stigma in particular, arises from the way society as a whole has come to view sex, all sex. The 'proof' that sex is bad is the existence of a HIV pandemic. But the evidence that the pandemic was driven by sex? Alas, there is none. That's why it's called prejudice.

Concurrency: the Favorite Plaything of the Sex-Obsessed HIV Industry

For a relatively short time, the notion of concurrency became the favorite plaything of the sex-obsessed HIV industry. They hypothesized, not just Africans with rampant and uncontrollable sexual urges, but Africans with sexual partnerships that overlapped with each other.

If serial monogamy refers to the practice of finishing one relationship before going on to another, concurrency increases the chances of infecting more than one person. Given normal probability of transmission through penile-vaginal sex, those subscribing to the purely sexual theory of HIV transmission need all the help they can get.

But some have speculated about another aspect of rapid transmission, which has been well demonstrated, but never clearly tied to concurrency. The probability of transmitting HIV is highest during the first three months of infection and during the last 9 months or one year. During the latent phase, which can last 8 years or so, probability of transmission is especially low.

So, if someone acquires HIV, they are highly infectious during the first few months. Sex-only HIV transmission theorists need that person to infect several people during that short period to explain exceptionally high prevalence found in some countries. Concurrency may help explain high prevalence, but it doesn't completely explain it.

More embarrassing for these adherents of the 'behavioral paradigm', the belief that sexual behavior accounts for the bulk of infections, is that concurrency doesn't appear to be very common in many countries, even countries with high HIV prevalence.

People like Jeffrey Eaton, Timothy Hallett and Geoffrey Garnett have gone to great lengths to push concurrency, and the behavioral paradigm in general, but they have even discovered that it just can't be pushed that far. They try to model the effects of relatively low levels of concurrency that also take into account the stage of HIV infection. They even use ridiculously high estimates of transmission rates.

But they are forced to conclude that "this model produces HIV epidemics that grow more slowly than those observed in southern Africa, suggesting that factors not included here—in particular, small groups with greater number of sexual partners and cofactors that increase HIV transmission—also contribute to accelerating the spread of HIV".

This is a completely deflating argument, showing that some level of concurrency has some influence on rates of transmission, possibly. The level of influence, like rates of concurrency, is not estimated. Perhaps it's not even possible to estimate it.

Another study suggests that many people in high prevalence countries don't have very many partners (Table 2). The percentage of people who had more than one partner in the last year before the study ranged from 6% in Malawi to 25% in Lesotho. Fair enough, Lesotho is a high HIV prevalence country, but so is Swaziland, where only 10% had more than one partner.

And having more than one partner is not the same as concurrency. Eaton et al find that "increasing from 10 to 11% of individuals having concurrent partnerships increased the mean endemic HIV prevalence from 3 to 7%." We can't assume concurrency is higher in high prevalence countries without arguing in a circle (though mathematical modeling is probably no stranger to circular arguments). What the researchers say may be true, but we don't know what truth it expresses.

Even if concurrency plays a role and that role can be quantified, how do we then explain the rise, peak and decline in HIV rates in most sub-Saharan African countries before most prevention programs started and long before the notion of concurrency became the popular plaything it is today?

Eaton et al conclude that "primary infection in the context of concurrent sexual partnerships may be the factor that has enabled HIV to spread through general populations to such high levels." They are entitled to conclude that it may be a factor, not the factor. And that doesn't really get us much further.

But there isn't much further to go when your only contribution to HIV transmission theory is that it is a sexually transmitted infection. It is, but to what extent? It is also transmitted from mother to child, by injecting drug use, through unsterile health care practices and even unsafe cosmetic practices.

If Eaton et al want a model that grows like some of the epidemics found in some sub-Saharan African countries, they need to factor in non-sexual transmission. Otherwise they will continue to be in the dark and to leave everyone else in the dark. And the useless HIV prevention strategies that have dominated the field for so many years will continue to fail.

The UNAIDS Paradox: Low Risk Sex Appears to be Risky in Africa

Aidsmap.com has an article about a study carried out in Uganda which shows that there is little evidence of an increase in risky sex since the widespread rollout of antiretroviral drugs (ARV). Many people have been worried that the (relatively) easy availability of such drugs could give rise to both HIV positive and negative people disregarding principles of 'safe' sex.

It is not just in Uganda and other African countries where there are worries that such increases in risky behavior could follow ARV rollout. Wealthy countries have shown that increases in risky behavior are a reality and that this could easily wipe out some of the gains that have been made over the years. People are just not as frightened of HIV as they used to be.

But in the case of Uganda, the study gives the impression that risky sexual behavior is not such a big thing there. More surprisingly, it sounds as if it never was. After starting treatment, some people engaged in higher levels of risky behavior but later this trend reduced. In the end, they reverted to pre-treatment levels.

Well, if pre-treatment levels of risky behavior are not worrying in HIV positive people, they must be even less worrying in HIV negative people. There have been other studies like this one, also giving the impression that levels of unsafe sexual behavior are fairly low. Not that anyone has produced data showing what could count as normal and what could count as high when it comes to sexual behavior.

Not only that, even those who talk about high levels of unsafe sex don't really show that levels really are higher than elsewhere. Nor do they appear to have any reliable data to show that higl levels of unsafe sex occur more in African countries, nor in countries and regions where HIV prevalence is high.

It can be odd listening to people talking about HIV because they appear to consider the issue important, but also, in a sense, unreal. For a start, they always talk about sex, especially illicit and unsafe sex. It's as if some sex, most sex, if they are to be believed, falls into that category, while a small amount does not.

But as to what constitutes a lot of sex, no one I have asked can really say. It has been suggested that people who are HIV positive have at least one different partner a week, perhaps more, but these are just assumptions. As to why it is even assumed that some people have so many partners, and I'm not doubting that some people do, it often seems to relate to the perceived number of people who go to bars and drink alcohol.

But the Ugandan study does confirm one thing; levels of unsafe sexual behavior are not, in general, high. They probably never were. There has never been evidence of a glorious time before the HIV epidemic, when hardly anyone engaged in unsafe sex. Nor for a time when levels of unsafe sex rocketed, allowing HIV to spread rapidly. Nor for a time when all this subsided and HIV transmission rates began to decline to present levels.

Other research leads to similar conclusions. The five yearly Demographic and Health Surveys show that those who engage in risky sex are often less likely to be infected with HIV than those who don't. Trials such as the CAPRISA microbicide trial showed that the majority of people had a few sexual experiences a month and most of them only had one partner.

The Uganda study also found that use of condoms among HIV positive people increased after they started treatment. This may well be, as claimed, due to 'incraesed counselling intensity'. But condom use wasn't very high to start off with. As a minimum, you would expect people being counselled and on treatment to take some extra precautions.

However, a substantial proportion of those most likely to transmit the virus still don't wear condoms. It's hard to know if the 'intensive counselling' really has all that much effect. And when you look at sexual behavior among HIV negative people, the many years of HIV prevention interventions look even less impressive.

But the article is 100% about sex. There is never a hint that transmission may occur through any other route. Non-sexual routes to HIV infection may well have been talked about earlier on in the epidemic and, in the case of Uganda, steps may have been taken to reduce their impact. But now sex has completely taken over.

The fact that the HIV industry is attributing declines in transmission to HIV prevention programs that only started a long time after the declines suggests that they don't know why transmission declined. They don't seem to know how to reduce transmission and they don't even seem too bothered by that.

If we still don't know why HIV spread and subsequently declined, after thirty years of research, then nor do we know what to do if transmission rates begin to increase again. Don't people find that frightening? UNAIDS' claim that Uganda's epidemic is driven by low risk sex is not credible.

UNAIDS: HIV Industry Misinformation is their Business

The constant baying for foreskins from the HIV industry has always been difficult to comprehend. Especially considering that the few countries where HIV prevalence is lower among circumcised men are actually anomalies, rather than the norm.

These HIV experts could just as easily have advocated against circumcision if they had selected a different few countries, where HIV transmission is higher among circumcised men.

Rather than making spurious assumptions about causality on the basis of non-statistically significant correlations, the industry should abandon circumcision. There are too many arguments against it and none for it that stand up to scrutiny.

A number of arguments against circumcision have been made for countries with low HIV prevalence, but when you take into account the conditions of health services in high prevalence countries, attempted arguments for circumcision still fall flat.

But far from backing off on the basis of poor trial results for circumcision as a HIV prevention intervention, the industry insists that the results are actually very good. That if people just wear condoms and get circumcised, they will be ok.

You may do a double take on reading the last paragraph: because circumcision only works if you use condoms. But if you use condoms, your circumcision status is irrelevant. Condoms give the best currently available protection against sexually transmitted HIV.

So people in developing countries are being asked to risk all sorts of consequences, including the risk of infection with hepatitis, bacterial infection or even HIV, for an operation that will not even protect them against HIV unless they also continue to use condoms.

They could opt to use condoms all the time, and would be well advised to do so. But because they have been promised some additional protection against infections and they haven't been warned about the risks, many people have already agreed to be circumcised and hundreds of thousands of others are being persuaded to do so. They may well be told they will still have to wear condoms, but what impact will that have after they have undergone an operation?

Not content to lie about circumcision and HIV alone, others claim that circumcision protects against human papilloma virus (HPV). Yet, a recent study found that circumcision is not associated with HPV in heterosexual men. Not only that, condoms don't give complete protection either.

The study confirms that the part that genital hygiene might play in HPV transmission was not considered. But if neither condoms nor circumcision give full protection, perhaps it's time for it to be considered. There is more than a suspicion that genital hygiene could play a major role in sexual health as a whole. It would be surprising if it didn't.

However, I'm not advocating genital hygiene as a sole protection against HIV, HPV or any other sexually transmitted infection. I'm advocating access to clean water and sanitation as a human right. I'm also advocating access to good education, especially health education, decent infrastructure and living conditions, and good health services.

If people in developing countries were allowed their basic rights, diseases such as HIV, HPV, diarreal conditions and acute respiratory infections would be decimated. Picking a few choice diseases and throwing money at them has never worked. The money spent on this vertical approach to diseases (as opposed to health) would be far better spent on basic human needs.

Global HIV Policy Too Prejudiced to End Pandemic in Africa

In an article in AlterNet, Jessi Fischer asks "Why Do We Vilify Male Sexuality"? But it's not just male sexuality that is vilified, it's sexuality in general. As a result of people's apparent desire to vilify sex, they seem anxious to seek out targets, people whose sexuality is perceived as most deserving of vilification, as opposed to their own sexuality, which is not.

When HIV was identified and thought to be exclusive to homosexual populations, many were happy to vilify men who have sex with men. Doing so was nothing new, after all. And when it was recognised that HIV also infected heterosexuals, sex workers, injecting drug users and 'promiscuous people' were vilified. They still are.

Sex was considered so important in the transmission of HIV that almost all large-scale HIV 'prevention' campaigns since the 1980s have concentrated on sex. In countries where it was possible to remove the threat of medical and other transmission of HIV, this was done, with a high level of success in rich countries. Less wealthy countries have had varying levels of success, some failing altogether.

As for poor countries, they didn't have a hope. Health services in the poorest countries were bad enough in the 60s and 70s but those countries who fell for the World Bank and IMF's 'structural adjustment' policies of the 80s, 90s and 2000s reduced health and other public services till most of their population hardly ever see a nurse, let alone a doctor or any kind of specialist.

Under international 'development' policies, health services, social services, education, infrastructure and anything else that could allow developing countries to develop were reduced, often to zero. Independently of HIV, although overlapping substantially with the pandemic, levels of health, education and overall development had already started to decline from the 1980s onwards.

It was very convenient to blame HIV for this, but the damage had already done. By the time HIV transmission rates had peaked and slowed down in the 90s and 2000s, structural adjustment and other policies, policies that continue to punish the poorest people in the world, had already destroyed whole populations.

Early on in the pandemic, it became obvious that HIV was not easily spread through sexual intercourse alone, especially not penile-vaginal sex. But those who had jumped on various political, religious and commercial bandwaggons weren't prepared to let go. The association of HIV with sex, especially promiscuous sex, was like a gift from the heavens.

HIV was, in a sense, just what development theorists had been looking for. They had been messing around with population control for decades, billions had been spent on persuading people in developing countries to use contraception, have fewer children, plan their families, etc. None of these attempts had been particularly productive, but the suggestion that they could hawk condoms as a means of protecting people from HIV, not just from unplanned pregnancies, was more than they could resist.

Billions more was spent on the same organizations which had done such a mediocre job for several decades, FHI, PSI, TFGI, and others (I assume there were some non-American institutions involved?). Unsurprisingly, they had even less effect on sexual behavior, maternal health and family planning than they had had in the past. But then, these weren't really the issues, were they?

The whole global HIV prevention effort was sidetracked by sex and has still to find its way back. This is not for lack of scientific evidence. The evidence has always pointed to the impossibility that serious HIV epidemics could be driven by sex alone. Serious levels of transmission only occur when the transmission route is highly efficient, such as through blood transfusions, mass vaccination campaigns, injecting drug use, etc.

But the international community was so enthralled by the apparent vindication of their view of Africans as animalistic, as not quite human, their policies are still completely skewed by such prejudices. African males are sexually incontinent and females are primarily victims, but also they have an insatiatable appetite for being pregnant, regardless of any danger to their own health or the health of their children. That's the story, anyhow.

And so the pinnacle of scientific endevour in HIV prevention is that we know how to prevent it; we just don't want to let go of our prejudices. Our prejudices are far more important than academic progress and, as for the lives, health and livelihood of generations of Africans, that has never been our major concern. And it probably never will be.

When Will UNAIDS Be Abolished?

When people find used hypodermic needles in areas where children play in Western countries, they are upset. Quite rightly so. They don't like the thought that their children are being exposed to injury and diseases, possibly even serious or deadly diseases.

But even many Westerners seem to believe that HIV 'dies' within seconds, minutes or some fairly short period, outside of the body. This is not what the US Center for Disease Control (CDC) says on the subject, although it may have said that at one time. Their current answer to the question 'How well does HIV survive outside the body?' is difficult to interpret.

But no matter how you interpret the risk, no one wants a possibly contaminated needle piercing their skin or that of their children. As well as the physical injury, there is also a risk that the needle is contaminated with hepatitis and it is almost certainly contaminated with bacteria.

So the CDC's comment about 'incorrect interpretations' of risk causing 'unnecessary alarm' seems injudicious. I know the question is about HIV but the answer really needs to address risk as a whole. Potentially, HIV can survive for days and even weeks, under the right conditions. Contact with contaminated needles and other instruments should be avoided and where this is not possible, medical advice is required.

However, the idea that the HIV does not live outside the body is widely held, by professionals and lay people. And in countries like Kenya, Tanzania and Uganda, it is far more dangerous to be unaware of the risks. The chances of medical or cosmetic equipment being contaminated in countries with high prevalence of HIV, hepatitis and other diseases can be very high.

You might think that there would be a lot of awareness of these risks and how to avoid them but I have rarely spoken to anyone who has considered the risks they face from contaminated instruments in health or cosmetic facilities.

UNAIDS dismisses the importance of any form of non-sexual HIV transmission, let alone transmission in health facilities. They grudgingly accept that a few percentage points of HIV transmission in East African countries may come from such routes. But they hardly mention cosmetic instruments, razors, tattooing equipment and the like, at all.

As a result, such transmission may be occurring at high rates and people are doing nothing about it. When they take their child to the hairdresser, or go themselves, they could be picking up scabies, hepatitis, HIV or some kind of bacterial infection. To help people avoid these risks, the best thing to do would be to inform them.

Risks in health facilities are more difficult to handle. Doctors, nurses and other health personnel can be pressed for time and it is not easy for patients, or those accompanying patients, to intervene. At best, personnel will be annoyed, at worst, they will refuse to treat the patient, give them poorer quality treatment or make them wait a long time.

The WHO has published data showing that as much as 14% of injections in developing countries are contaminated with HIV and they have unpublished data showing that this figure can be a lot higher. A large proportion of hepatitis B and C is transmitted through contaminted needles. And an estimated 70% of all injections are not even necessary.

When there is even the hint that someone in a Western country may have come into contact with contaminated equipment, there is an investigation to establish how procedures could have resulted in such a risk. And anyone who may have been affected, even going back years, and through thousands of records, is contacted and screened.

Not only does this sort of investigation and screening of possible use of contaminated equipment not take place in developing countries but UNAIDS and others seem keen to deny that such things, which happen in the best resourced health systems in the world, could possibly happen in the worst resourced health systems in the world.

HIV Policy Needs to Follow Health Policy, Not Vice Versa

Following my last post, I received a comment raising the issue of the role of sexually transmitted infections (STI) in HIV transmission. This is a vital issue so I gave a brief response but promised to answer more fully in a blog post.

Firstly, health is not just a matter of absence of disease, so health policies should aim to prevent diseases where possible, as well as treat them.

This has clearly not been done with STIs. Preventable and treatable STIs are endemic in many developing countries and, regardless of whether they play a role in HIV transmission, sexual health is in urgent need of prioritization.

Very high levels of STIs, and of all easily preventable or curable diseases, are a symptom of poor health services, services that have been declining for decades. Concentration on HIV has often meant that STIs and other diseases have been ignored, so this has added to the serious STI epidemics that have developed.

However, the role of STIs in HIV epidemics has not been clearly demonstrated and there have been conflicting reports, especially where tests with treating STIs as a HIV prevention intervention have been carried out.

There is an interesting article on this subject called "Confound it: latent lessons from the Mwanza trial of STD treatment to reduce HIV transmission", by David Gisselquist and John Potterat. This is about the STI treatment trial in Mwanza, Tanzania which, according to the researchers involved, showed that reducing STIs could reduce HIV transmission.

The researchers' claim is odd because STIs were not reduced much during the trial, yet HIV transmission did seem to be reduced. Also, similar trials were carried out in two other locations and neither of them demonstrated any benefits for STI treatment.

Gisselquist and Potterat have two suggestions as to why the trial results in Mwanza differed so much from the two in Uganda. For a start, those taking part in the Mwanza trial appear to have received safe health care, which is something most East Africans don't receive. And there happened to be an injection safety initiative taking place at the same time as the STI trial.

The authors warn that continuing to target STIs without also improving health services by making it far safer, especially in relation to injection practices, there is a risk that transmission of HIV and other blood borne viruses will increase.

In the mid 1980s in Nairobi, HIV rates were found to be over 80% among sex workers at a time when they were extremely low among males in the city. The hypothesis, still the dominant hypothesis about HIV transmission in African countries, was that these women were infected through sexual intercourse with HIV positive men.

But if few men were infected, that seems unlikely. To explain such high transmission rates among women, even though they were engaging in high risk sex on a regular basis, the possibility that they were infected through health services must be investigated.

After all, there was an STI reduction program in Nairobi targetting sex workers in the early 1980s. As far as I know, this program did not target sex worker clients, which may well explain why HIV prevalence among men, in Nairobi and most other parts of Kenya, has never been as high as it has been among women.

Not only is it possible for HIV to be transmitted rapidly through unsafe health care, it is far more likely than transmission through unsafe sex. The transmission probability for many health practices is many times higher than the transmission probability for penile-vaginal sex.

Blood transfusions, for which the transmission probability is extremely high, may well have been made safer very early on in the epidemic. But most people don't have transfusions, whereas many people do receive injections and other invasive procedures. And the safety of these procedures has never been adequately assurred.

If these comments are even partly correct, not only is current UNAIDS policy allowing many people to become infected with HIV and other diseases; but it is also ensuring that many people become infected who might remain healthy if they ignore the health advice they are likely to receive. That's if they even have the option to ignore the advice.

Targeting STIs is a good thing in itself and may even reduce sexual transmission of HIV. But there is little point in reducing sexual transmission while at the same time increasing non-sexual transmission, especially that through unsafe injections and other procedures. HIV policy needs to follow health policy, not the other way around.

What Do UNAIDS Call a HIV Positive African? Promiscuous

To continue yesterday's theme about the difference between HIV in Western countries and HIV in high prevalence countries, most of which are in sub-Saharan Africa (SSA):

Treatment with antiretrovirals (ART) is widely touted as a type of HIV prevention because if people are responding to ART their viral load should be low and they should be far less likely to transmit the virus.

In Switzerland, in particular, HIV positive people on ART have been told that they could have unprotected sex and that the risk of transmission would be very low.

However, in SSA countries, people are not given the same advice. But also, it has been suggested that people who are on ART could experience 'disinhibition'. They could engage in higher risk sex because they think their treatment means they are less likely to transmit the virus.

Conditions in SSA are very different from those in Switzerland. For a start, perhaps a majority of people, certainly a lot of people, don't know their HIV status. When it comes to preventing sexually transmitted HIV, the more precautions people take, the better.

Even those who promote the rather unconvincing 'treatment is prevention' strategy admit that if treatment results in significant disinhibition, the modeled reductions in transmission will not occur.

So far, so good. It could be argued that conditions are so different in SSA and in Switzerland that the advice given to HIV positive people on ART should also differ.

But many articles have come out about how disinhibition doesn't occur in SSA countries. And at the same time, articles have also come out about how it does occur in Switzerland.

It would be very convenient if levels of disinhibition in SSA were not high enough to cancel out gains, but it also sounds a lot like wishful thinking. Especially if, in practice, disinhibition does occur in Switzerland.

The orthodox line about HIV, a virus that is difficult to transmit sexually, is that over 80, perhaps over 90% of it is transmitted through heterosexual sex in African countries.

In wealthy countries, the virus is usually transmitted through anal sex or through intravenous drug use. It is not much transmitted through heterosexual sex.

We are supposed to believe that, despite the difficulty of transmitting HIV through heterosexual sex, Africans do so because they have such exraordinary sex lives. But if they have these extraordinary sex lives, why is disinhibition so unlikely?

As I say, probably wishful thinking. Which is not really a good basis for a HIV treatment strategy, and even less so for a prevention strategy.

In countries where hundreds of thousands or even millions of people are infected with HIV, so many will not know their status and so many will not be on treatment even if they need it, treatment and prevention need to continue to be driven by separate initiatives.

There is little point in putting more and more people on treatment and hoping that they will adhere to the drug regime as they need to, supposing their supply of drugs even keeps up with their needs, unless efforts are also made to reduce the incidence of new infections. Drugupplies are often too unreliable to ensure that viral load will always be kept low.

But many people, also, are not being infected sexually. This means that they will not know what risks they are facing when they visit health facilities or anywhere else they may be exposed to contaminated blood or bodily fluids.

It is popular to talk about the need to test as many people as possible and to test people as often as possible. Despite this, most people have never been tested and the ones that have been, have only been tested once.

Testing on its own is not enough. It also needs to be established, for each person who becomes infected, how they are infected. The fact that they are sexually active does not mean they were infected sexually. Many people are sexually active and some of them become infected with HIV, but their partner is not positive. This means they were probably not infected sexualy.

It may take a bit of work to establish how people were infected, especially as most people will blame their own sexual behavior because they have the heterosexual theory of African HIV transmission drummed into them. But it is vital to take appropriate steps to reduce HIV transmission. Assuming that most transmission is sexual does not lead to appropriate steps.

In addition to testing and retesting, there needs to be an honest and creadible assessment of the risks people face and of all the likely routes to transmission. Those who are positive need to be assessed for treatment and those who are negative need to be made aware of all the HIV transmission risks they face, sexual and non-sexual.

HIV transmission rates are still very high in many countries. Transmission needs to be reduced. Treatment of those infected alone is not likely to reduce transmission enough. We have to keep our eye on non-sexual transmission as well as sexual transmission. Concentrating on sexual transmission alone, for example, by targeting discordant couples, is not going to protect them from non-sexual transmission.

All that remains now for HIV epidemics to be turned around is for UNAIDS and their HIV industry friends to lose their highly prejudiced views of African people and to treat Africans as they do their own employees and Westerners, who seem to be considered far more important than Africans.

Apparently, the Truth About HIV is Relative to Nationality and Wealth

A typical article about HIV reads "Cheating spouses have always caused problems for their marriages." That may be so, but it does not mean that 'cheating' drives HIV epidemics in high prevalence African countries. Data about sexual behavior and HIV prevalence show that many people engaging in 'safe' sex become infected with HIV and many engaging in 'unsafe' sex remain uninfected.

It has long been recognised that the majority of HIV infections in several countries, Uganda, Kenya and others, come from people in long term relationships who only have one partner, many of whom take adequate precautions against sexually transmitted HIV.

Of course, you could engage in unsafe sex and become infected non-sexually. You are unlikely to ever find out because if you live in a resource poor country, especially an African country, it will be concluded that you were infected sexually.

Whether you are infected sexually or otherwise, it's good to take precautions against infection of any kind. But it would be pretty stupid to protect yourself against sexually transmitted HIV, for example, and turn a blind eye to the fact that your children are all receiving invasive medical treatment with unsterilized equipment.

Who would be stupid enough to do that? Perhaps people who have been bashed over the head for years about their sexual deviance. Indeed, their sexual deviance is considered so bad that the possibility of their being infected non-sexually by a virus that is difficult to transmit sexually is rarely mentioned.

The article in question, as they usually do, rants on about a discordant couple, where one partner is infected and the other is not. There is no mention of how the one partner became infected nor of how the other is in danger of being infected non-sexually as well as sexually.

Well, UNAIDS and the AIDS orthodoxy are not going to change their tune in a hurry. But they haven't even managed to persuade very many people to use condoms to protect themselves from infection or to get careful advice when they wish to become pregnant. They are even failing in their favorite field, sex.

So underinformed are the majority of people that they know as little about the dual role condoms play in reducing transmission of sexually transmitted infections and preventing unplanned pregnancy as they knew many years ago, before most people had heard about HIV.

The entire process of HIV prevention seems to consist of misinforming people. And the article even refers to a 'myth' about HIV negative people being protected when their partner is on antiretroviral drugs (ARV).

But this is not a myth, even according to the HIV orthodoxy. Big pharma and HIV Incorporated are trying to sell the idea that treatment is prevention; that because those on treatment have a low viral load, they are less likely to infect their partner.

Well, like the myth in the first paragraph, it's more of a half truth. The HIV/AIDS industry has been trying to sell the idea of taking ARVs instead of bothering to carry out any real prevention programs that they might not be able to make huge sums of money out of.

In some Western countries, discordant couples are advised that they can have safe unprotected sex as long as the infected partner has a low viral load as a result of successful ARV adherence. But this is not the advice given in African countries.

And it would be very stupid advice. If we haven't established how most people are becoming infected with HIV, we cannot advise them about what is and what is not safe behavior, about what they can do and what they must avoid.

And that underlines the biggest risk regarding HIV: being African. If you are African, you will not be  told that you face serious risks in health facilities and cosmetic facilities, not just through your sexual partner.

If you are African, you are almost condemned to being infected without anyone noticing until it is too late, especially if you are a woman who is foolish enough to get pregnant.

And when you are found to be HIV positive, because you are African, it will be assumed that you were infected sexually, regardless of how well you may have protected yourself, whether you have had sex or not or anything else. To be African, in the eyes of the orthodoxy, is to be promiscuous.

The most illogical thing is, just because people are promiscuous, and some are, everywhere, that doesn't mean you will be infected sexually. Therefore, the fact that you are infected does not mean you are promiscuous. UNAIDS and the rest of the industry may be obsessed with your sexual behavior, but they don't actually know anything about it, their frequent pronouncements notwithstanding.

An interesting feature of HIV myths is the fact that both those who are in danger of being infected with HIV or of infecting others, and those who are supposed to be responsible for reducing transmission, all have their own myths. And what is a myth in poor countries may be the orthodoxy in rich countries, and vice versa.

Giving Up Sex Will Not Protect You From HIV in Africa

All the HIV/AIDS industry has to do is put out a press release and the global media reproduces it over and over again, without question or analysis. It's hard to believe that such slavish repetition is what counts as journalism.

Even Alternet.org, with their pretentions of offering something different, just pick up whatever is thrown at them. A recent article, typical end of year stuff, rehashes all the hypes of the year about HIV, how it is all going to be sorted out in the end by technology.

The main worry about this sort of article is not that technology will never develop to the extent that it can treat, prevent and even cure HIV one day. The worry is that we don't have to wait till that happens before we do anything to prevent a lot, perhaps the majority of HIV infections in high prevalence countries. Yet, we are still waiting.

UNAIDS and their pharmaceutical industry chums have been putting about the idea that if only people would have less sex, everything would be ok. But some people don't have sex, or they are very careful when they do, and they still end up HIV positive. Others have lots of sex, even unsafe sex, and they generally do not end up HIV positive.

We even know who is likely to be infected. If they are female and living in a handful of mainly African countries, between one third and half of them will be HIV positive or dead before they are 40. Doesn't that strike people as a bit odd?

If they are not from one of those countries in question, they can have as much sex as they like, as long as it is penile-vaginal sex. Outside of high and medium prevalence countries, where epidemics are 'generalized', that is, not confined to high-risk groups, HIV is transmitted by intravenous drug use and anal sex, generally.

Unless you subscribe to the racist and sexist 'oversexed African' view of HIV transmission, and you're in the esteemed company of the entire HIV/AIDS industry if you do, you have to conclude that there is something we are not being told about HIV.

How can it be an almost exclusively sexually transmitted infection in a handful of countries and almost exclusively transmitted by anal sex and intravenous drug use in all other countries?

Even the HIV/AIDS industry knows that HIV is not exclusively, perhaps is not even mainly, sexually transmitted. They don't like to admit it, but sexual transmission of HIV is not very efficient.

However, non-sexual transmission modes, such as unsafe healthcare, are higly efficient. UNAIDS and the UN as a whole are well aware of this and they warn their own employees to avoid medical facilities in high HIV prevalence countries.

For some reason, they don't think it necessary to warn people living in high prevalence countries. Every tourist coming to African countries can read warnings about using health facilities in these countries. It's just people living in them who are not warned.

Worse still, UNAIDS denies that unsafe healthcare plays a significant role in transmitting HIV. They estimate that it may account for 2-5%, but that is certainly not enough for them to consider warning people who have to use health facilities that lack trained personnel, basic equipment and even soap and water.

Testing is of little value to populations as a whole if no attempt is made to find out how people are being infected. And no attempt is being made to find out. If someone is African, it is assumed they were infected sexually, even if they don't have sex, don't have unsafe sex or have a partner who is not infected.

Never mind the technologies that so many billions of aid money is going into, or the technologies that may one be developed. People are being infected, suffering, infecting other people and dying because they are being told half truths and outright lies.

HIV is tranmitted non-sexually, especially through unsafe healthcare. We need to tell people that so they can protect themselves and protect their partners and families. People will not be fully protected if they have 'safe' sex, take various drugs, use condoms or take any other precautions against sexual transmission. They also need access to safe healthcare.

HIV Stigma Doesn't Come from Ignorance, it Comes from Lies

UNAIDS' and the Aids industry's stigmatizing of HIV positive people has many consequences. If you resolutely claim that HIV is almost always transmitted sexually in African countries, people in African countries who are HIV positive will continue to be stigmatized. Telling everyone that HIV is driven by promiscuity means that everyone who is infected is considered to be promiscuous.

Some of the most vulnerable victims of the industry's stigmatization are sex workers or those assumed to be sex workers. Of course, according to UNAIDS, a huge precentage of African women are sex workers, even if they don't know it themselves.

Many women, whether sex workers or not, are aware of sexually transmitted HIV. Most women attend antenatal clinics when they are pregnant, if they can reach one. Those who do engage in transactional sex visit clinics if they can. In fact, the majority of women probably follow the strictures of the HIV industry, especially where they think they might be at risk.

Most women are not, however, aware of non-sexual HIV risks. Those visiting antenatal clinics or giving birth in health facilities are unaware that the majority of injections given in developing countries (70%) are unneccessary. A huge amount of HIV and hepatitis is probably transmitted in such facilities due to reuse of injecting or other equipment.

In some countries, HIV prevalence among sex workers has been found to be as high as 70 or 80%. How can this be? Especially when prevalence among men in the same areas is 5% or less. It is not possible for three quarters of heterosexual women to be infected when such a small percentage of men are infected.

Prevalence among young women of child-bearing age in some countries is 30 or 40%. It is nowhere near this level among men of any age. Who is infecting these women? The Aids industry doesn't even bother checking the status of partners of all these HIV positive women, let alone find out how they became infected.

Even if African women are as promiscuous as UNAIDS and the rest of the industry tell us, we don't know how they are becoming infected sexually, unless a sizeable percentage of men are also infected. There simply is no small group of HIV positive men who sleep with almost all the sexually active women in a particular population.

Sex workers face risks, there's no doubt about that. They have been stigmatized by UNAIDS and the industry to the extent that many of them are afraid to visit health facilities, though they know they have to. And they may be right to be afraid. Perhaps the massive rates of HIV prevalence found among sex workers and others attending sexually transmitted infection (STI) clinics face more serious risks in the clinics than they do from their clients.

But sex workers also face stigmatization and persecution from their clients, who often refuse to pay or demand more abusive or dangerous types of sex. They face stigmatization from police and security people and often have to pay bribes, in cash or by sexual favors. And they are stigmatized by the public, who have been told by UNAIDS and the industry that sex workers spread HIV.

Nauseating articles about how sex workers are so badly treated, when the same articles simply spread the industry stigma, do little to help. Sex workers need to know the truth: that HIV is not spread by sex alone. Indeed, everyone needs to know the truth. Sex may well spread HIV but so does unsafe medical treatment, cosmetic treatment, tattooing, traditional medicine and any other practices that may involve contaminated blood or other bodily fluids.

One of the biggest threats to reducing HIV transmission seems to be the very HIV researchers who don't bother investigating non-sexual HIV transmission, especially in health facilities for sex workers and for pregnant women. They seem utterly oblivious to the possibility that sex is not always transmitted sexually, even when it happens right under under their noses.

It's time to investigate the massive levels of HIV among sex workers whose clients are almost all HIV negative, the mothers whose husbands are HIV negative, the babies and children whose mothers are HIV negative.

Of course sex workers are treated badly and that needs to stop. But articles that simply repeat the half truths about HIV almost always being sexually transmitted is simply adding to the neglect of their health and welfare. The very stigma the Aids industry claims to abhor comes from the industry itself.

Of course the poverty that so many people have to suffer is terrible. But it is not poverty or lack of education, terrible things in themselves, that are driving the epidemic. HIV is a virus that is sometimes transmitted sexually, but not always, probably not even often. We can't continue to refuse to investigate the relatively simple question of the extent to which HIV is transmitted non-sexually.

It's not just sex worker clients, police and others who abuse sex workers and non-sex workers alike: it's researchers and academics who claim to be helping but who don't seem to be able to see Africans as ordinary human beings. Perhaps if they take that first step, the rest will be easy.

UNAIDS Happily Stoke Up HIV Epidemic Using Public Money

Someone recently raised the question in a Kenyan newspaper of whether a negative HIV test result in one partner implied that the other partner is also negative. The answer is a resounding 'No', but the person replying was not quite clear enough on the matter: "There are instances where one partner is HIV-negative and the other is HIV-positive".

In many African countries, half of the couples infected with HIV are discordant, meaning that only one partner is infected. And about half of those in such discordant relationships are female. People in discordant relationships can and do have unprotected sex, often for years, without transmitting the virus. And in couples where both partners are infected, it has often been found that they were both infected by a different source.

More worryingly, you can not imply the HIV status of a woman from the HIV status of her children. Not only can HIV positive women have HIV negative children but HIV negative women often seem to end up with HIV positive children. UNAIDS and others deny that this phenomenon is significant and very little research has been carried out to find out if they are right.

Indeed, the very mention of terms like 'nosocomial', 'iatrogenic', 'hospital acquired' (all meaning roughly the same thing) is something of a taboo. In the same way that people all over the world see talk about sex as taboo, the highly paid and overqualified people who make up the AIDS industry see talk about non-sexual HIV transmission as taboo. Perhaps it's a cultural trait or some kind of institutional tradition, who knows.

Things in Mozambique may be different. Most of the relevant publications are in Portuguese, but Dr David Gisselquist recently sent me some figures for HIV positive children with HIV negative mothers. It was kindly translated by a researcher who knows Portuguese. I just wonder how much other vital data is available but only in a language I don't know. I suspect there's a lot.

Anyhow, the proportion of HIV positive children with HIV negative mothers is around 30%. This is an alarming figure, suggesting that infants and children, as well as mothers (and the population as a whole), face serious risks of HIV transmission from unsafe healthcare.

The AIDS industry has always tried to diminish the likelihood of any form of non-sexual HIV transmission and a similarly embarrassing revelation a few years ago, that time in Swaziland, was dismissed as being a result of babies being raised by someone other than their birth mother. This unconvincing argument is quite telling, too; the industry is not interested and will not investigate.

Cock-ups in health services are not confined to dirt-poor countries with disasterous infrastructures and extreme shortages of skilled personnel and equipment. They also occur in countries that have very high quality, accessible healthcare systems. There have been numerous scares about healthcare transmission of HIV, hepatitis and other conditions. And recently there was a scare about a mother in the UK who was given the wrong (expressed) breastmilk for her infant, several times.

The figures for Mozambique are unlikely to reveal the full picture. Women with HIV positive children who are HIV positive themselves may not have infected their children. And it is also possible that some children may have infected their mother. Or they may both have been infected through different routes. Many women are found to seroconvert late in their pregnancy or just after giving birth. The AIDS industry assumes that this is because they continue to have unprotected sex, probably often with strangers, during their pregnancy.

This is an appalling attitude towards African people and, as it is not the received view of non-Africans, it must also be considered racist, institutionally racist. The picture that is painted of women is similarly bigoted and entirely sexist. In Western countries, if a HIV negative woman is found to have a HIV positive child, there is an investigation, not an outpouring of racist bilge.

To misrepresent HIV as a purely sexually transmitted virus (in African countries, alone) is to condemn people to a lifelong, debilitating disease that will likely reduce the sufferer's lifespan. It also condemns many people to a life of stigma, persecution, isolation and violence.

To stand by and watch people being needlessly infected with HIV is bad enough but to brand them as stupid, careless, ignorant, and even as evil, is beyond belief. The HIV industry, especially UNAIDS, need to be recognised as being more than just ineffective; they are also playing a significant part in fuelling the HIV epidemic.

It's OK, Apparently Journalists Are Supposed to Lie

In an article about the Polish journalist and writer, Ryszard Kapuscinski, Neal Ascherson claims that "there is no floodlit wire frontier between literature and reporting". This is interesting because he feels that being a "great story teller" does not make someone a liar. Which is true, except when they are supposed to be writing an article that people assume is 'reportage'.

I don't know about Kapuscinski but if there is no frontier between literature and reporting then why would anyone bother to read the daily tripe? Journalists churn out a lot of rubbish concerning things they know precious little about, but people read papers and listen to radios and TVs every day to find out what is happening in the world. When they read some jumped up hack going on about how there couldn't be global warming because it's very cold today, they think that the whole issue about climate change has been trumped up.

So when it comes to genetically modified organisms (GMO), consumers of journalistic bullshit (the majority of mainstream reporting) think of Frankenstein foods, or whatever crap the 'profession' has dreamed up to ensure that the last thing people do is think or become informed in any way. Neal Ascherson may write for The Guardian, a 'moderate' paper, but lying and reporting are not the same thing and if a journalist lies, he or she is a liar.

What I'm saying about GMOs will probably be of no interest to journalists because I am not opposed to them just because they may be dangerous to humans, animals, plants, water supplies, in general, the whole global ecosystem. Although, I admit it, the fact that no one knows exactly what effect long term consumption of GMOs has on those who consume them (because no credible research has been done), does seem like a glaring omission. I am opposed to the fact that a few multinationals want to control the whole of humanity's ability to provide enough food for itself. Not only do they want this but they already control a massive proportion of global food production. To cap it all, many of the most powerful idiots in the world are in favour of this, with the support of...big media owners.

Ok, I've skipped past the journalists because they are just doing a job and they are paid for by some revolting Murdoch-like character who is trying to do for global media what Monsanto is trying to do for food production. But Ascherson makes a good point, don't bother reading what journalists have to say, unless you like a good read. As for science reporting in the mainstream media, forget it.

Domination of global food production by a few multinationals should be bad enough but approval of GM potatoes or any other GMO in Europe (or anywhere else) will also be a disaster because such crops will contaminate other crops around them. We know that they will because the evidence is clear from every field trial of GMOs. We know that there are other dangerous drawbacks to GM crops and also that none of the promised advantages of these crops have materialised. So what they hell are we growing them for?

I wouldn't wish to blame lying journalists for doing any more than following orders, or whatever it is they do, but if they want to brown-nose the bosses of companies like Monsanto, the least they could do is declare their interest. Because every time they throw in a straw man argument like 'Frankenstein foods', they are scoring a goal for the GMO industry. Monsanto can just claim to be using the crops for animal feed or biofuels. But then the problem doesn't go away. Once GMOs are used, the damage is done.

There are enough arguments against the use of GMOs, aside from the dangers to human health. But these arguments are much more difficult to answer. So rather than get the biotech industry to answer them, they are presented with arguments that they have a ready prepared response to. A response that has been well sold by journalists. And have you noticed the way articles often point out how widespread GMO contamination already is, as if to say it's only a matter of time before there is no longer any point in protesting? That's how they got GM cotton into India. Thanks journalists.