Sex, Not Unsafe Medical Practices, Main Cause for HIV Transmission in Sub-Saharan Africa, Study Says
Unprotected sex -- not unsafe medical practices -- is the primary HIV transmission route in sub-Saharan Africa, according to a study published in today's issue of Nature, Reuters Health reports. The study, conducted by researchers from the University of Oxford, compared the pattern of the spread of HIV to that of hepatitis C, another bloodborne disease, in order to test recent theories that the AIDS epidemic in Africa was caused by unsafe medical practices and blood transfusions (Reuters Health, 4/16). A team of eight researchers from the United States and Germany led by anthropologist David Gisselquist published in the March issue of the International Journal of STD & AIDS several studies supporting the unsafe medical practices theory. The researchers 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 researchers concluded that unsafe medical practices held a "much greater risk" for HIV transmission. The researchers stated that previous studies conducted on HIV transmission, which they reexamined for their 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 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, 3/28).
Hepatitis C is More Potent, Less Prevalent
"If the [medical practices] hypothesis were true, the epidemic history of HIV in the region should resemble that of diseases caused by bloodborne pathogens known to have only a small element of sexual transmission," the researchers write in the Nature study (Walker et al., Nature, 4/17). The Oxford researchers compared the transmission patterns of hepatitis C to those of HIV to check for similarities. A needle tainted with hepatitis C is six times more likely to infect a person than a needle contaminated with HIV, according to the authors. In addition, HIV is more common than hepatitis C in Africa, whereas hepatitis C is more common than HIV worldwide, according to Reuters Health. The researchers conclude that because HIV is more prevalent in the region despite being less potent than hepatitis C in terms of medical transmission, HIV must be transmitted primarly through routes other than unsafe medical practices. For example, South Africa's HIV prevalence increased from less than 1% in 1990 to nearly 25% in 2000, while the prevalence of hepatitis C has remained steady. The researchers recommend that in light of their conclusion, prevention efforts should continue to be focused on promoting safe sex (Reuters Health, 4/16).