PHA-Exchange> Expert group stresses that unsafe sex is primary mode of HIV transmission in Africa

[claudio]

From: "Dieter Neuvians MD" <neuvians at mweb.co.za>

> Expert group stresses that unsafe sex is primary mode of HIV transmission
in Africa
> --------------------------------------------------------------------------
--------> 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 fea-
> ture of prevention programmes in the region.
>
> Today the World Health Organization (WHO) and the Joint United Nations
Pro-
> gramme 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 trans-
> mission 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
un-
> safe sexual practices continue to be responsible for the overwhelming ma-
> jority 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 sexu-
> ally 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 vi-
> rus-2); in sexually active couples both partners are often infected; and,
> there is no consistent association between higher HIV rates and lower in-
> jection 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 uncer-
> tainty 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 coun-
> tries. 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
neces-
> sary, 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 pro-
> viders and vaccinators, provision of single-use injection equipment and
> proper 'sharps' disposal. More needs to be done to eliminate unsafe injec-
> tion practices throughout the world. To further this work, WHO has just
is-
> sued 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 informa-
> tion 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.
>
> _______________________________
> For more information, please contact Dominique de Santis, UNAIDS, Geneva,
> (+41 22) 791 4509 or (+41 79) 254 6803 (mobile), Andrew Shih, UNAIDS, New
> York, (+ 1 212) 584 5012, or Chris Powell, WHO, Geneva, (+41 22) 791 2888
> or (+41 79) 217 3425 (mobile) or Christine McNab (+41 22) 791 4688 or (+41
> 79) 254 6815 (mobile). You may also visit the UNAIDS Home Page on the
> Internet for more information about the programme (http://www.unaids.org).
>