AFRO-NETS> HIV transmission in Africa: Unsafe sex or unsafe medical practice?

[A Odutola <chpss_abo@yahoo.com>]

HIV transmission in Africa: Unsafe sex or unsafe medical practice?
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Short Opinion: - A. Odutola, Nigeria

Science, despite its averment for truth based on evidence, also cun-
ningly pays obeisance to politics where truth is often the first vic-
tim of self serving agenda. 

The recent debate on whether HIV transmission in Africa is predomi-
nantly driven by 'unsafe sex' or 'unsafe medical practices' has been 
cloaked in a lot of science but with a virulent but quiet undertone 
of agenda protection.

The first salvo on this debate was fired by Gisselquist and associate 
in late 2002 when, using science of course, they challenged the pre-
vailing conventional wisdom by suggesting that probably more than 35% 
of HIV infections in Africa cannot be accounted for by heterosexual 
transmission. Unsafe medical practices, including unsafe and un-
sterile needle/instrument usage, female genital mutilations and un-
safe blood transmission were fingered as bigger culprits.[1] Heresy! 
Heresy in the court of population agenda. But heresy is not unknown 
in the political court of science with sometimes unfortunate chagrin 
to the heretical.

Just so that "safer sex promotion must remain the primary feature of 
[HIV] prevention programmes in the [Africa] region" and that 'safe 
sex' messages are not sabotaged in the hugely important process of 
preventing the spread of HIV in Africa especially, the World Health 
Organization (WHO)[2] and fellow protagonists [3] since the Gis-
selquist publication, have spared no resource in also using science 
to re-emphasize the pre-eminence of 'unsafe sex' over 'unsafe medical 
practices' in the transmission of HIV/AIDS in Africa. In common par-
lance, a "my dog is better than your dog" controversy is being played 
out and the general scientific community and the public at large can-
not but be amused as it is well known that except in the minds of the 
political, a dog is a dog by all names and anatomy. 

'Unsafe sex' and 'unsafe medical practices' are both probably un-
equally culpable and bad for the control of HIV transmission in Af-
rica and the controversy over pre-eminence is simply strategic hair-
splitting.


Reference:
[1]. Gisselquist, D. et al. 2002; HIV infections in sub-Saharan Af-
rica not explained by sexual or vertical transmission. Int. J. STD 
AIDS 13, 657-666.
ftp://acithn.uq.edu.au/signfiles/HIVinfectSubSaharaAfricaNotExplained.pdf
Accessed April 24, 2003

[2]. WHO: Expert group stresses that unsafe sex is primary mode of 
transmission of HIV in Africa. 2003; WHO Media Release. April 14.
http://www.who.int/mediacentre/statements/2003/statement5/en/
Accessed April 24, 2003

[3]. Walker, P.R. et al. 2003; Sexual transmission of HIV in Africa. 
Nature 422, 679
http://www.nature.com/cgi-taf/DynaPage.taf?file=/nature/journal/v422/n6933/full/422679a_fs.html
Accessed April 24, 2003

--
A. Odutola
Centre for Health Policy & Strategic Studies (CHPSS)*
Lagos, Nigeria
mailto:chpss_abo@yahoo.com
http://www.expage.com/chpsshomepage
http://www.datelinehealth-africa.net

* CHPSS works to promote better health for all in Nigeria and the 
rest of Africa through research, policy advocacy and information dis-
semination.
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