Given estimated transmission rates of one in 500 from women to men and one in 1000 from men to women, the chances of an individual transmitting HIV several times are very small, credulous claims to the contrary in the mainstream media notwithstanding.
But when a health facility outbreak occurs, numerous infections can result in quick succession. Infections can even spread to several health facilities and further transmissions can continue for lengthy periods within those facilities.
At least 23 children in a hospital in Gujurat have been infected after receiving contaminated blood transfusions. The blood is said to have come from the hospital blood bank, so there may be others infected, as yet undiscovered.
The children infected attend the hospital regularly as they need frequent medical treatment. But anyone attending the hospital needing blood or blood products could be infected, if the infections came through the blood bank.
Could such transmissions occur in African countries? Well, the answer given by UNAIDS is ‘no’. Or at least, they claim such transmissions rarely occur and would only account for about 1% of all HIV transmissions (see Kenya’s Modes of Transmission Survey, for example). But this claim, repeated throughout the HIV industry literature, has always looked like wishful thinking.
What’s to stop such transmissions from occuring? All countries writing HIV/AIDS strategies mention ‘universal precautions’ to prevent HIV transmission through contaminated blood and possibly other types of health care infection. But using the term ‘universal precautions’ does not mean those precautions have any reality outside of the endless supply of HIV/AIDS strategy documents one can find.
According to Service Provision Assessments, on the other hand (see the latest report from Tanzania, for example), which look at health facility conditions and preparedness regarding infection control, most health facilities are lacking many of the most basic capacities. Other documentation tells a similar story.
The fact that one rarely reads about health facility outbreaks of HIV in African countries maybe be because health facilities have, somewhat miraculously, managed to avoid them. Or it may be because many people in some of the worst affected countries do not have access to health facilities, thereby protecting them from such infections.
Whatever the reason or reasons, the issue of hospital acquired infections, especially infections with HIV, hepatitis and other serious illnesses, is in urgent need of investigation.
The attitude of UNAIDS and friends appears to be that African people can’t be allowed to think health facilities may be dangerous places. But if they are dangerous, we have a duty to inform people and a further duty to improve conditions.
For advice on how to avoid HIV and other infections through blood transfusions, read about the POST strategy (Patient Observed Sterile Treatment) on this site.