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HIV infections in sub-Saharan Africa not explained by sexual or vertical
transmission.

by David Gisselquist, PhD,
Richard Rothenberg, MD, MPH,
John Potterat, BA,
Ernest Drucker, PhD,

Correspondence and reprint requests to:
David Gisselquist
mailto:david_gisselquist at yahoo.com

SUMMARY

An expanding body of evidence challenges the conventional hypothesis that
sexual transmission is responsible for more than 90% of adult HIV infections
in Africa. Differences in epidemic trajectories across Africa do not
correspond to differences in sexual behaviour. Studies among African couples
find low rates of heterosexual transmission, as in developed countries. Many
studies report HIV infections in African adults with no sexual exposure to
HIV and in children with HIV-negative mothers. Unexplained high rates of HIV
incidence have been observed in African women during antenatal and
postpartum periods. Many studies show 20%-40% of HIV infections in African
adults associated with injections (though direction of causation is
unknown). These and other findings that challenge the conventional
hypothesis point to the possibility that HIV transmission through unsafe
medical care may be an important factor in Africa's HIV epidemic. More
research is warranted to clarify risks for HIV transmission through health
care.

International Journal of STD & AIDS Royal Society of Medicine, October 2002
http://www.rsm.ac.uk/pub/std.htm