Dirty needles 'not main source of HIV in Africa'
The researchers argue that if this had been the case, then the expansion of HIV/AIDS in Africa should have followed the same pattern as the spread of infection of other known blood-borne pathogens, such as the hepatitis C virus (HCV).
Writing in the journal Nature, the researchers use data from South Africa to show that levels of HCV infection remained virtually constant during the 1990s. In the same period, however, HIV infections increased from less than 1 per cent to almost 25 per cent of the adult population.
They conclude that, although it is important to highlight the issue of pathogen transmission through, for example, the re-use of needles for injections, such transmission “is not the dominant contributor to the African HIV epidemic”.
Such a claim was made two months ago in a series of papers in the journal International Journal of STD & AIDS, published by the Royal Society of Medicine in London, which argued that heterosexual transmission accounted for less than one third of HIV incidence in Africa (see ‘HIV transmission claims stir controversy’, 21 February 2003).
The authors based their conclusion on epidemiological records from 1984 to 1988, and backed up their claims by pointing out that high rates of HIV in South Africa “have paralleled aggressive efforts to deliver health care to rural populations”.
These conclusions were quickly rebuffed by the World Health Organisation, worried that misleading signals might be sent out to those seeking the control the spread of the epidemic (see 'Experts confirm most HIV passed by unsafe sex', 19 March 2003).
They have now been directly challenged by the group of British researchers, who come from the department of zoology at the University of Oxford, one of the world’s leading centres for epidemiological studies.
The researchers say that the lack of correlation between the way in which HIV and HCV have spread — not only in Africa but also in the rest of the world — undermines any claim that unsafe medical practices are the primary cause of increased HIV infection rates in Africa.
“Consequently the introduction of widespread drug treatment for HIV and other cofactor infections, as well as continued efforts to encourage safe sex, are urgently required to reduce the spread of HIV in Africa,” they write.
Link to research paper in Nature
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