Resolved: We Must Stop Ignoring Bloodborne HIV in Africa Why do so manyHIV-positive children in Africa have HIV-negative mothers?Forexample, approximately 30% of HIV-positive kids aged 0-11 years haveHIV-negative mothers in Mozambique (see pp. 177-181 in:http://www.measuredhs.com/pubs/pdf/AIS8/AIS8.pdf).Why are so manyvirgin men and women found with HIV? In the Republic of Congo,for example, virgin women aged 15-49 years have higher HIV prevalencethan all women, 4.2% vs 4.1% (see p. 101 in:http://www.measuredhs.com/pubs/pdf/AIS7/AIS7.pdf).The personal storiesbehind these statistics are hard to fit with the common view thatalmost all infections are from sex. Why has there been so littleattention and response to Africans with unexplained infections?THE PURPOSE OFTHIS NOTE IS TO INITIATE DEBATE ABOUT WHETHER TO CONTINUE TO IGNORENON-SEXUAL HIV Infections IN AFRICA. To do so, this note presentsfour arguments for AIDS activists, both in Africa and elsewhere, torecognize and respond to HIV from skin-piercing procedures in Africanhealth care and cosmetic services.1.DE-STIGMATIZING HIV/AIDS: Programsfor HIV prevention in Africa – including especially foreign-fundedprograms -- focus almost exclusively on sex. With all attention onsex, the emotions, prejudices, and controversies around sex naturallyspill over into HIV programs. Thus, it is not only wrong to thinkthat all African HIV comes from sex (see points 3 and 4, below), butalso confusing and distracting. Currently, stigma against HIV is sogreat that most people with unexplained infections keep silent, so asnot to be accused of sexual behaviors that some people don’t like.When the public discourse is corrected to recognize blood-borne aswell as sexual HIV (see: http://dontgetstuck.wordpress.com),people with HIV from blood risks will be able to speak out withoutfacing stigma compounded by charges they are lying. And they willthen be able to contribute to public efforts to make health care andcosmetic services safe. 2. PREVENTING HIVINFECTIONS: Ensuring that medical facilities are safe willnot only prevent HIV infection but also the transmission of otherblood borne pathogens. Across Africa, HIV prevalence is lower incountries where more people are aware of blood-borne risks for HIV;see: http://dontgetstuck.wordpress.com/africans-aware-of/3. SEX ALONECAN’T EXPLAIN AFRICA’s HIV EPIDEMICS: Allattempts to explain Africa’s epidemics as exclusively sexual havefailed to find anything that is so different about sex in Africa thatcould account for Africa’s high rates of HIV prevalence.Studies find that Africans have fewer partners and use condoms morethan Americans and Europeans. Circumcision is lesscommon in Europethan Africa. Sex can’t explain how HIV prevalence is lower afterlong term wars, and among people living further from health clinics.Sex is a risk for HIV because so many Africans are infected – buthow are so many infected? 4. EVIDENCE THATAFRICANS GET HIV FROM SKIN-PIERCING EVENTS: Alot of evidence shows HIV transmission through skin-piercingprocedures in Africa.Evidence is both old and new. For example:(a) In 1985, ProjectSIDA in Kinshasa,Zaire(now the Democratic Republic of Congo), tested inpatient andoutpatient children aged 1-24 months and their mothers for HIV.Seventeen (39%) of 44 HIV-positive children had HIV-negative mothers.Among children with HIV-negative mothers, “medical injectionsseemed to be the most important risk factor for HIV…” The studyteam noted, “Injections are often administered in dispensarieswhich reuse needles and syringes yet may not adequatelysterilize them” (Mannet al, Riskfactors for human immunodeficiency virus seropositivity amongchildren 1-24 months old in Kinshasa, Zaire. Lancet1986, ii: 654-7. p. 656.)(b) Around 1990,WHO’s Global Programme on AIDS coordinated a study in Rwanda,Uganda,Tanzania,and Zambiato test in-patient children 6-59 months old and their mothers forHIV. Sixty-one (1.1%) of 5, read more..
