A more rational and scientific approach to AIDS is needed, says expert

November 26, 2008

The Secretariat of the Joint United Nations Programme on HIV/AIDS (UNAIDS) has lost valuable ground by ignoring for years the contribution of long-term concurrent relationships to Africa's AIDS epidemic, claims an expert ahead of World AIDS Day on bmj.com today.

UNAIDS may be "contributing to the mystification of AIDS in Africa by promoting a needlessly overcomplicated view of the epidemic", says Helen Epstein, an independent consultant on public health in developing countries.

She argues that long term, overlapping, or "concurrent" partnerships provide at least a partial explanation for the staggeringly high infection rates in the general population in some African countries, and calls for UNAIDS to reassess its handling of scientific data.

Epstein speculates that UNAIDS' tendency to emphasize only typical high risk behaviours such as casual sex and prostitution may have hindered prevention, promoted denial and stigma, and contributed to HIV associated domestic violence by implying that people with HIV are necessarily promiscuous.

In fact, African people do not seem to have more sexual partners than people in other countries, but they are more likely to have two or three long term "concurrent" partnerships at a time, and this creates a "virtual superhighway" for HIV.

Condom use is rare on this "superhighway" because long term relationships, even concurrent ones, are seldom perceived as risky. This may explain why reductions in sexual partners have been a crucial factor wherever infection rates have fallen in Africa, she says. For example, in Uganda, a 60% fall in casual partnerships coincided with a 70% fall in HIV prevalence during the 1990s. In addition, declines in HIV prevalence in the US gay community and Thailand were also accompanied by rapid declines in multiple partnerships.

According to Epstein, for years UNAIDS overlooked independent reports about the importance of partner reduction, and until 2006, did not mention long-term concurrency in its reports on sexual behaviour.

Concurrency does not imply a simple solution to the AIDS crisis in Africa, she says, but education about the "superhighway" could help motivate behavioural change, especially partner reduction, and should be integrated into all AIDS education programmes in Africa.

Epstein concludes by calling on the new UNAIDS director and its governing board to re-evaluate the agency's political and scientific roles, and suggests that scientific issues be addressed through a more open process of research and peer review, rather than by one, largely unregulated UN agency.

In a second feature, Bob Roehr examines how institutionalised homophobia and the criminalisation of homosexual activity are aiding the spread of HIV and hindering efforts to provide treatment and prevention among men who have sex with men. According to Dr Peter Piot, director of UNAIDS, homophobia is one of the top five obstacles to stopping the epidemic.

Source: British Medical Journal


Rank not rated yet
Tags

Relevant PhysicsForums posts

More news stories

Study finds that anti-diabetic medication can prevent the long-term effects of maternal obesity

In a study to be presented today at the Society for Maternal-Fetal Medicine's annual meeting, The Pregnancy Meeting, in Dallas, Texas, researchers will report findings that show that short therapy with the anti-diabetic medication ...

Medicine & Health / Health

created 21 hours ago | popularity 5 / 5 (1) | comments 1

FDA-approved drug rapidly clears amyloid from the brain, reverses Alzheimer's symptoms in mice

Neuroscientists at Case Western Reserve University School of Medicine have made a dramatic breakthrough in their efforts to find a cure for Alzheimer's disease. The researchers' findings, published in the journal Science, show t ...

Medicine & Health / Neuroscience

created Feb 09, 2012 | popularity 4.9 / 5 (53) | comments 20 | with audio podcast

Teen school drop-outs three times as likely to be on benefits in later life

Teen school drop-outs are almost three times as likely to be on benefits in later life as their peers who complete their schooling, indicates research published online in the Journal of Epidemiology and Community Health.

Medicine & Health / Health

created Feb 06, 2012 | popularity not rated yet | comments 11

Green tea found to reduce disability in the elderly

(Medical Xpress) -- A lot of research has been done over the past several years looking into the health benefits of green tea. As a result, scientists have found that regular consumption of the beverage leads ...

Medicine & Health / Health

created Feb 07, 2012 | popularity 4.4 / 5 (14) | comments 10 | with audio podcast report

Amateur football players not always keen on returning to play after ACL injuries

Despite the known success rates of reconstructive Anterior Cruciate Ligament (ACL) surgery, the number of high school and collegiate football players returning to play may not be as high as anticipated, say researchers presenting ...

Medicine & Health / Health

created 21 hours ago | popularity not rated yet | comments 0


Google might launch Drive for cloud storage soon

(PhysOrg.com) -- Google's next big move, according to the Wall Street Journal, is a cloud storage service called Drive. Hardly first to the plate, Google is simply catching up to introducing its cloud reposi ...

Latin America mining boom clashes with conservation

Latin America is experiencing a mining boom as prices rise fuelled by a hike in global demand, but the region is also being hit by a wave of violent protests, strikes and rallies by environmentalists.

Love a click away in Indonesia's Twitter Republic

He was a geeky kid from Yogyakarta, she a glamorous city girl in Jakarta. In a country with one of the world's most vibrant social networking scenes they fell in love on Twitter.

Walney offshore wind farm is world's biggest (for now)

(PhysOrg.com) -- The Walney wind farm on the Irish Sea--characterized by high tides, waves and windy weather--officially opened this week. The farm is treated in the press as a very big deal as the Walney ...

GPS court ruling leaves US phone tracking unclear

A US Supreme Court decision requiring a warrant to place a GPS device on the car of a criminal suspect leaves unresolved the bigger issue of police tracking using mobile phones, legal experts say.

Europeans protest controversial Internet pact

Tens of thousands of people marched in protests in more than a dozen European cities Saturday against a controversial anti-online piracy pact that critics say could curtail Internet freedom.