Unsafe Medical Practices Primary Mode of HIV Transmission Among South African Children, Study Says
Unsafe medical practices are the primary mode of HIV transmission among children in South Africa, according to a study published in the British Journal of Obstetrics and Gynaecology, BBC News reports (BBC News, 5/6). The study was conducted by Stuart Brody of the University of Tubingen in Germany and anthropologist David Gisselquist, John Potterat and Ernest Drucker of the Albert Einstein College of Medicine in New York (Brody et al., British Journal of Obstetrics and Gynecology, 5/6). A team of eight researchers from the United States and Germany led by Gisselquist in March published in the International Journal of STD & AIDS three studies supporting a theory that unsafe medical practices and blood transfusions have been primarily responsible for the spread of HIV in sub-Saharan Africa. 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, 4/17).
Infection Rates Do Not Match Mother-To-Child Transmission Rates
For the BJOG study, the researchers examined statistics from a study conducted last year by the Human Sciences Research Council of South Africa. The HSRC study found that 5.6%, or 670,000, of South African children between the ages of two and 14 are HIV-positive (BBC News, 5/6). Data from the same study showed that the HIV prevalence among white children was 11%, while the prevalence among white adults was 5.7%. The researchers said this discrepancy pointed to another method of HIV transmission among children other than vertical transmission (Woodman, Reuters Health, 5/6). The researchers also rejected suggestions that the children could have contracted the disease through unsafe sex or as a result of sexual abuse, BBC News reports. "For hundreds of thousands of South African children to have acquired HIV sexually, inordinately high levels of childhood sexual exposure would be required, a phenomenon unlikely to have been overlooked by pediatricians," the study says, according to BBC News. The researchers predicted that the children became infected through "parenteral exposures in health care settings," such as injections with unsterilized needles and transfusions of unscreened blood. They concluded that urgent action must be taken to improve conditions in South African clinics, adding that the research could be applied to countries with "similar epidemiological characteristics" in order to "protect patients from their own medical care system." Both the South African government and the United Nations have rejected such findings. "I believe the matter needs to be much more closely interrogated before we form conclusions about the cause" of HIV transmission, Dr. Nono Simelela, head of the South African health department's HIV/AIDS program, said (BBC News, 5/6). A UNAIDS/WHO expert group in March said that unsafe sex, not unsafe medical practices, is the primary mode of HIV transmission in sub-Saharan Africa (Kaiser Daily HIV/AIDS Report, 3/17). In addition, researchers from the University of Oxford last month published a study in Nature supporting the theory that unsafe sex was the primary transmission route for HIV infection in Africa (Kaiser Daily HIV/AIDS Report, 4/17).