E-drug: Origin of AIDS (cont'd)
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[cross-posted for Afro-nets with thanks BS]
Expert group stresses that unsafe sex is primary mode of HIV
transmission in Africa
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Source:
http://www.unaids.org/whatsnew/press/eng/HIVinjections140303_en.html
Geneva , 14 March 2003 - An expert group has reaffirmed that unsafe sexual
practices are responsible for the vast majority of HIV infections in
sub Saharan Africa, and that safer sex promotion must remain the
primary feature of prevention programmes in the region.
Today the World Health Organization (WHO) and the Joint United
Nations Programme on HIV/AIDS (UNAIDS) hosted an expert consultation
which addressed
issues related to unsafe injection practices and HIV in healthcare contexts
and evaluated the relative contribution of unsafe injections to HIV
transmission in sub-Saharan Africa.
Following a review of evidence, which included recent articles
suggesting that a majority of HIV infections in sub-Saharan Africa
are due to unsafe medical practices, particularly injections, the
experts concluded that such suggestions are not supported by the vast
majority of evidence and that unsafe sexual practices continue to be
responsible for the overwhelming majority of HIV infections. While a
combination of prevention measures are required to tackle all modes
of HIV transmission, safer sex promotion must remain the primary
feature of prevention programmes in the region.
This position is strongly supported by epidemiological and biomedical data.
For example, children between 5-14 years, who are generally not yet
sexually active, have very low infection rates; age-specific
infection rates among young women and men strongly follow patterns of
sexual behaviour and those of other sexually transmitted infections
(such as herpes simplex virus-2); in sexually active couples both
partners are often infected; and, there is no consistent association
between higher HIV rates and lower injection safety standards.
Modelling of the epidemic with the best available information also
shows that the overwhelming majority of infections are due to unsafe
sex. WHO has previously estimated that unsafe injection practices
account for about 2.5% HIV infections in sub-Saharan Africa. Although
there is a margin of uncertainty around this estimate, the conclusion
remains that unsafe sex is by far the predominant mode of
transmission in sub-Saharan Africa.
With approximately 3.5 million Africans becoming infected in 2002
alone, and a total of 29.4 million adults and children living with
HIV/AIDS in the region, the prevention of HIV through the practice of
safer sex should be the mainstay of the response to AIDS in the
region. Discussions about the importance of other modes of
transmission should at no time weaken this central part of the
response.
The expert consultation also emphasized the importance of achieving
safe and appropriate use of injections in both the formal and
informal health care sectors of low and middle income countries, as
in high income countries. There are an estimated 16 billion
injections given globally each year, of which an estimated 30 per
cent are unsafe due to the reuse of equipment. The participants of
the meeting fully agreed that safe medical injections are crucial to
minimise the risk of transmission of not only HIV, but other
pathogens such as hepatitis B and hepatitis C in healthcare settings,
and to maintain confidence in the healthcare system.
Injections are vital for immunization programmes and for the provision of
life-saving treatment. Injections should be used only when medically
necessary, and should be given using single use equipment which is
then disposed of safely. In the past several years, major efforts and
resources have been devoted to enhancing injection safety in the
healthcare setting through better planning of services including
immunization, training of care providers and vaccinators, provision
of single-use injection equipment and proper 'sharps' disposal. More
needs to be done to eliminate unsafe injection practices throughout
the world. To further this work, WHO has just issued a framework to
assist countries with all aspects of the provision of safe
injections, entitled "Managing an Injection Safety Policy".
In the context of the AIDS epidemic, WHO and UNAIDS continue to strive to
understand the global and local epidemiology of HIV, consider new
information as it arises, and provide leadership to prevent HIV
infection from all sources, including unsafe sex, mother-to-child
transmission, blood and blood products and unsafe injections.