Let it be sexual: how health care transmission of AIDS in Africa was ignored
- PMID: 12665437
- DOI: 10.1258/095646203762869151
Let it be sexual: how health care transmission of AIDS in Africa was ignored
Abstract
The consensus among influential AIDS experts that heterosexual transmission accounts for 90% of HIV infections in African adults emerged no later than 1988. We examine evidence available through 1988, including risk measures associating HIV with sexual behaviour, health care, and socioeconomic variables, HIV in children, and risks for HIV in prostitutes and STD patients. Evidence permits the interpretation that health care exposures caused more HIV than sexual transmission. In general population studies, crude risk measures associate more than half of HIV infections in adults with health care exposures. Early studies did not resolve questions about direction of causation (between injections and HIV) and confound (between injections and STD). Preconceptions about African sexuality and a desire to maintain public trust in health care may have encouraged discounting of evidence. We urge renewed, evidence-based, investigations into the proportion of African HIV from non-sexual exposures.
Comment in
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Heterosexual HIV transmission in Africa: recent findings and future directions.Int J STD AIDS. 2003 Jun;14(6):428. doi: 10.1258/095646203765371349. Int J STD AIDS. 2003. PMID: 12816673 No abstract available.
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Let it be sexual: health care transmission of AIDS in Africa was ignored.Int J STD AIDS. 2003 Aug;14(8):572-3. doi: 10.1258/095646203767869228. Int J STD AIDS. 2003. PMID: 12935391 No abstract available.
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HIV in Africa following unsafe injections.Int J STD AIDS. 2003 Aug;14(8):573-4. doi: 10.1258/095646203767869237. Int J STD AIDS. 2003. PMID: 12935392 No abstract available.
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HIV transmission in Africa in ways other than heterosexual sex.Int J STD AIDS. 2003 Sep;14(9):646. doi: 10.1258/095646203322301185. Int J STD AIDS. 2003. PMID: 14511509 No abstract available.
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Let it be sexual--selection, aggregation and distortion used to construct a case against sexual transmission.Int J STD AIDS. 2003 Nov;14(11):782-4; author reply 784-6. doi: 10.1258/09564620360725537. Int J STD AIDS. 2003. PMID: 14624744 No abstract available.
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Transmission of HIV via unsafe injection or unsafe sex? Anomalies or misunderstanding?Int J STD AIDS. 2004 Jan;15(1):61-3; author reply 63-5. doi: 10.1258/095646204322637308. Int J STD AIDS. 2004. PMID: 14769175 No abstract available.
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Non-sexual transmission of HIV.Int J STD AIDS. 2004 Jan;15(1):61. doi: 10.1258/095646204322637290. Int J STD AIDS. 2004. PMID: 14769176 No abstract available.
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Reply to 'Unsafe healthcare drives spread of African HIV'.Int J STD AIDS. 2004 Jan;15(1):65-7. doi: 10.1258/095646204322637326. Int J STD AIDS. 2004. PMID: 14769178 No abstract available.
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MOTION: Experts have not just been 'seeing what they wanted to see' by 'ignoring' health care transmission of AIDS in Africa. Sexual transmission is indeed the major mode of transmission. PROPOSAL: Initiatives to prevent sexual transmission of HIV in Africa should not be over-shadowed by current debate.Int J STD AIDS. 2004 Sep;15(9):619-22; discussion 623-5. doi: 10.1258/0956462041724262. Int J STD AIDS. 2004. PMID: 15339371 No abstract available.
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HIV in Africa - still a major matter of unsafe sex.Int J STD AIDS. 2004 Oct;15(10):709-10; author reply 710-1. doi: 10.1177/095646240401501015. Int J STD AIDS. 2004. PMID: 15479511 No abstract available.
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