E-drug: HIV & needles controversy
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[crossposted from afro-nets. With thanks. BS]
HIV transmission in Africa: Unsafe sex or unsafe medical practice?
Short Opinion: - A. Odutola, Nigeria
Science, despite its averment for truth based on evidence, also
cunningly pays obeisance to politics where truth is often the first
victim of self serving agenda.
The recent debate on whether HIV transmission in Africa is
predominantly 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
prevailing 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 unsterile needle/instrument usage, female genital
mutilations and unsafe 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
Gisselquist 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 parlance, a "my dog is better than your dog" controversy
is being played out and the general scientific community and the
public at large cannot 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
unequally culpable and bad for the control of HIV transmission in
Africa and the controversy over pre-eminence is simply strategic
hairsplitting.
A. Odutola
Centre for Health Policy & Strategic Studies (CHPSS)*
Lagos, Nigeria
e-mail: 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
dissemination.
References:
[1]. Gisselquist, D. et al. 2002; HIV infections in sub-Saharan Africa
not explained by sexual or vertical transmission. Int. J. STD AIDS 13,
657-666.
ftp://acithn.uq.edu.au/signfiles/HIVinfectSubSaharaAfricaNotExplaine
d.pdf
[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/
[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
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