My first big shock when I started to follow HIV related issues in East Africa was that it was assumed almost all Transmission was sexual in Africa (though nowhere else). Then, to 'work out' how this could possibly generate such massive epidemics, there was also the tendency to go from the number infected, or said to be infected, to the absurdly high levels of unsafe sexual behavior that would be needed to explain high levels of heterosexual transmission of HIV. There has never been any evidence that unsafe heterosexual sex alone could explain Africa's worst HIV epidemics. But all the 'work' to prevent infection appeared to concentrate on sexual transmission.
If not all HIV is transmitted sexually, many interventions that target sexual behavior, whether levels are real or assumed, will fail. Abstinence and other associated campaigns didn't even sound plausible before they were implemented, but enormous amounts of money was ploughed into them. Some equally dubious interventions were dreamed up and most probably also had little positive effect; as for any negative effects, these are unlikely to have been measured, let alone alluded to in the copious self-congratulatory literature that has emerged from what became the extremely lucrative HIV industry.
When circumcision was mooted as a possible intervention, it seemed to suffer from the above problem; it would, at best, protect against heterosexual transmission; it would not protect men who have sex with men, infants who are infected by their mothers or intravenous drug users. Indeed, it turned out that it wouldn't protect women either, and probably increases transmission from men to women. It will not reduce non-sexual transmission of any kind, including that through unsafe healthcare or cosmetic practices. Worse, in the sub-standard health facilities that ordinary Africans are forced to use, mass male circumcision programs might add to the problem, with men being infected in the health facility where the operation is carried out.
But those receiving circumcision related funding continue to insist on the effectiveness of such programs, shouting down any opposition, churning out figures which could be interpreted to show that male circumcision reduce transmission from women to men, but never actually engaging with the opposition. There are now so many problems with male circumcision as a strategy that the whole exercise to circumcise between 22 and 38 million African men should be suspended. There is so much disinformation and consequent misunderstanding that the campaign is unlikely to do any good and is in serious danger of doing a lot of harm. At best, it is just another neo-colonial excess of the kind that probably ensured that HIV would become the pandemic that it now is.
Kenya's Nairobi Star is currently doing a great job adding to the obfuscation that seems to pass for scientific journalism. The article 'Study Claiming Cut Does Not Inhibit HIV Rejected' makes a shaky start by incorrectly suggesting the study was not published or that its findings were refuted, or were even addressed by those promoting circumcision. The cited claims from the study are, in fact, correct, but they are only the tip of the iceberg. Interviewing those who would have a lot to lose if the circumcision program was suspended and asking their opinion is easy enough. But is it adequate journalism? Does the public really need more of the selective use of factoids to justify spending hundreds of millions of dollars on a campaign that is likely to be of so little benefit (at best)?
Other countries have less to say about the latest paper, one of several that has managed to get through the HIV industry's censorship process (peer review). Uganda's press has commented on circumcision from time to time, but only to beat the orthodox drum. It is claimed that 600,000 men have already been circumcised under the program since 2009, but it is unclear where this figure comes from. Natu read more..
Friday, 20 July 2012
Transmission Of Hiv-Male Circumcision-HIV
Thursday, 14 June 2012
Child Hiv Transmission-African Countries-Sexual Behavior-Hiv Prevalence
Despite the monstrous quantities of 'unsafe' sex that Africans are claimed to engage in by UNAIDS and other HIV institutions, HIV is not at all distributed evenly. Prevalence ranges from less than 1% in some African countries, a lot less than in some US cities, to more than 25% of the adult population in others (and even 50% in some demographic groups). Even within high prevalence countries HIV is not distributed evenly. In many African countries the virus tends to be far more common in cities, close to main roads, close to health facilities, among wealthier and better educated people, etc. It is also generally far more common among women than among men.
Other research has found HIV prevalence to be higher in areas where diseases such as schistosomiasis (bilharzia) and malaria are higher. However, as these both tend to be higher among less wealthy people with lower levels of education and in rural, as opposed to urban areas, there is more than a suggestion that HIV transmission may have widely varying risk factors. Yet UNAIDS and friends tend not to dwell on most forms of non-sexual risk in Africa.
As David Gisselquist writes in the Don't Get Stuck With HIV website: "Unlike Western countries, where almost all HIV transmission occurs outside families, a lot of HIV transmission in Africa happens within families – mother-to-child and spouse-to-spouse transmission together account for an estimated 45% of new infections." Not only is a lot of HIV not transmitted sexually, but a lot is not transmitted through 'unsafe' sex. Many of these couples where at least one partner is infected have no sexual risks. Hundreds of thousands of new infections every year occur through these two routes.
In Africa, then, the main groups are those at risk of mother to child transmission and married couples, especially couples where one partner has been infected. It's as likely to be the female as the male partner, but how does the index partner become infected, the first in the couple? Sex, says UNAIDS, but sex with whom, how much sex and what kind of sex? Heterosexual sex is not an efficient means of transmitting HIV. Gisselquist is suggesting that the focus of international HIV reduction efforts in African countries should address these and other risk groups, where sexual risk is very likely to be low but HIV prevalence is high; this could cut as many as 700,000 transmissions annually.
A serious set of risk factors could arise from unsafe healthcare and perhaps even unsafe cosmetic services. It's not just that conditions in healthcare and cosmetic facilities in African countries are primitive but also that many people are not aware that such risks exist; if they are not aware of the risks, they will not know that they need to avoid them, nor how to avoid them. But if they are aware, they will also realize that a person's HIV status is not a reliable indication of their sexual behavior. This should reassure some who have been brainwashed to associate HIV with 'immoral' behavior; many women, especially, have been beaten by their partners, ostracized by their communities and even killed because of the incorrect association of HIV with sexual behavior.
The HIV industry does talk a lot about the importance of HIV testing. But they also put people off testing where being positive has such terrible consequences. If people were to know that there were other, non-sexual risks, the stigma associated with testing and with having (or being thought to have) HIV should reduce. People who know their status don't tend to take risks, neither sexual nor non-sexual; but they must also be advised of the non-sexual risks. Those who are infected non-sexually can be involved in sexual transmission just as easily as those who are infected sexually. But in the current climate of sex-obsessed HIV policies, they are unlikely to know about non-sexual risk.
Prevention of mother to child HIV transmission is vital if the mother is already infec read more..
Sunday, 4 March 2012
Sex Trafficking-London Olympics-South Africa-World Cup
The usual rubbish that comes out in the press before a big international sporting event is back, according to the New Internatonalist: journalists throughout the 'free' press are already salivating about the '40,000 (or some such large number) forced prostitutes' who will be compelled to work during the London Olympics. The same kind of unresearched bumf came out before the World Cup in South Africa and various other sporting events, going back years. It's not even specualtion; there is nothing to support the articles but guesswork and other, equally underresearched articles from other, equally idiotic journalists.The worrying aspect of the articles before the South Africa World Cup is that the country has some of the worst figures for HIV prevalence in the world. Therefore, half a million or a million visitors (depending on which source you believe) faced a very real risk of being infected with HIV, hepatitis or other blood-borne diseases if they happened to go for a tattoo, dental treatment, medical treatment or any number of other procedures. UNAIDS, despite being aware that such risks exist, choose not to inform Africans, preferring just to warn their own employees. When it comes to Africans, their response is that 80-90% of transmission is from heterosexual contact. But in the run-up to the World Cup, they didn't even warn visitors to the country.As the New Internationalist points out, the figure is purely imaginary, probably inflated by those who feel all sex work is also sex trafficking. One of the problems with this is that there is little way of telling where the real trafficking is taking place, and therefore where to concentrate efforts to reduce it. But why traffic thousands of people for a very short event, anyway? 40,000 sex workers would barely get enough business from the Olympics attendees who happen to be male, sexually active and remotely interested in having sex with someone who has been forced into the business against their will (as opposed to those who make a choice to be sex workers, for whatever reason).There are people being trafficked, but if police concentrate all their efforts on commercial sex work, they will have difficulty identifying those who are doing it against their will. And if they think trafficked sex workers will suddenly be easy to find during the olympics, this is not going to be their 'lucky break'. But I'm sure the police know that, even if journalists don't (I'd like to say tabloid journalists but I don't think it is confined to them). Apparently there is increased police activity, with the predictable excesses that go with such measures, but let's hope they quickly realize that they have better things to do.Luckily, unlike in South Africa, there is little risk of being infected with HIV or anything else through medical or cosmetic exposure. At least, people won't face any higher a risk than patients currently do in UK health facilities. But sudden spikes in media and political interest in such issues doesn't help anyone, the women who are mistreated by the police, women and girls who happen to be trafficked, or anyone. The various illegal practices that surround sex work, which probably arise from the fact that it hasn't yet been decriminalized, are likely to continue, unaffected by the waxing and waning of these mostly trumped-up moral crusades.[For more about non-sexual HIV risks, such as through unsafe healthcare practices, see the Don't Get Stuck With HIV site.] read more..