From Nigel Hawkes and Michael Dynes at The Times Online:
“THE African Aids pandemic was caused more by careless use of needles in healthcare than by unsafe sex, a report published today by an international group of scientists says.
They estimate that more than half the cases of Aids in Africa before 1988 were caused by unsterilised needles. The claim, directly challenging the belief that 90 per cent of cases were sexually transmitted, implies that the African Aids pandemic is largely the result of unsafe medical practices and mismanaged vaccination campaigns.
The team says that the evidence was discounted because of “preconceptions about African sexuality and a desire to maintain public trust in healthcare”.
Aids experts yesterday rejected the theory, without denying that some HIV infections were caused by dirty needles. “There was an element of infection through medical interventions,” Professor Michael Adler, of University College London Medical School, said. “But I am extremely doubtful that it could have been as large as they claim.”
The team making the claims includes experts in HIV and public health and is led by David Gisselquist, an anthropologist from Pennsylvania, a private consultant, and Dr John Potterat, an infectious diseases specialist from Colorado. It also included experts from Emory University School of Medicine in Atlanta and Albert Einstein College of Medicine in New York.
In three separate articles in International Journal of STD and Aids, it says that only about 30 per cent of Aids in Africa is the result of sexual transmission, not the 90 per cent usually claimed.
The “anomalies” that it found may have alternative explanations, the team acknowledges. “Dispassionate assessment of our conclusions admittedly depends on a willing suspension of disbelief, since the current paradigm is deeply embedded,” the experts say.
Dr Gisselquist said yesterday that he had found no reliable study to back up the 1988 estimate that 90 per cent of HIV infections were sexually transmitted. The figure “did not fit the data available at the time” and suggested epidemiology and propaganda had become intertwined.
The aim of the new research was not to scare people, he said, but to show the importance of carrying out medical procedures correctly, such as using syringes only once. “People can get quality healthcare in Africa, it is just the difference between doing it right and doing it wrong,” he said.
If he is right, it is not only Africa, but also Asia and China where misuse of needles has pushed up HIV infection. Experts do concede that in many countries the re-use of needles, perhaps with only a cursorary soak in a bowl of dirty water between injections, is a serious problem….”