UNAIDS/WHO Expert Group Reaffirms Unsafe Sex Is Primary Mode of HIV Transmission in Africa
A UNAIDS/WHO expert group on Friday reaffirmed that unsafe sex, not unsafe medical practices, is the primary mode of HIV transmission in sub-Saharan Africa, according to an UNAIDS/WHO joint press statement (UNAIDS/WHO release, 3/14). The statement addresses claims made in three papers published in the March issue of the International Journal of STD & AIDS, which said that despite the consensus among AIDS organizations that heterosexual contact has accounted for 90% of HIV cases in Africa, only one-third of the total cases have been transmitted in this manner; the articles conclude that unsafe medical practices are a "much greater risk" in HIV transmission. The findings are based on a study conducted by a team of eight researchers from the United States and Germany led by anthropologist David Gisselquist that reexamined research on HIV epidemiology conducted in Africa up to 1988. The researchers state that previous studies failed to account for the fact that HIV transmission in Africa did not follow the same pattern of other sexually transmitted diseases and that high rates of HIV/AIDS can be attributed to the use of contaminated blood transfusions, the reuse of dirty needles in the administration of vaccinations and injections and the use of improperly cleaned surgical instruments (Kaiser Daily HIV/AIDS Report, 3/17). The UNAIDS/WHO expert group said that such suggestions "are not supported by the vast majority of evidence." The "primary feature" of HIV/AIDS prevention programs should therefore be the promotion of safe sex, the statement said (UNAIDS/WHO release, 3/14). However, the statement did acknowledge the dangers of unsafe medical practices (Times, 3/15). The statement noted that because an estimated 30% of the 16 billion injections given worldwide each year are unsafe due to the reuse of needles, safe medical injections are "crucial" in minimizing the risk of transmission of HIV and other diseases. WHO has issued a set of policy guidelines, titled "Managing an Injection Safety Policy," to assist countries with the provision of safe injection programs (UNAIDS/WHO release, 3/14).
Physicians for Human Rights Urges Action
Physicians for Human Rights at the WHO/UNAIDS meeting on Friday released a 50-page preliminary report, titled "HIV Transmission in the Medical Setting," that offers policy recommendations for the development of programs addressing injection safety, blood transfusion safety and universal precautions for the prevention of HIV transmission (Physicians for Human Rights release, 3/13). "While the discussion of the number of people who become infected with HIV through unsafe injections and other medical modes is one that should take place, PHR urges WHO, UNAIDS, national HIV/AIDS programs, and others who are responding to the pandemic to focus their energies not on debating numbers, but on implementing programs and initiating new, life-saving policies," the report states, adding that "the most effective HIV/AIDS prevention strategy will be one that responds aggressively to all sources of infections" (Friedman, PHR report, 3/13).