You might expect research into prevention of non-sexually transmitted HIV to start with the available literature. But when the research is carried out by Bjorn Lomborg’s RethinkHIV, you’d be mistaken. They have already produced three papers that ignore entirely the substantial literature which shows that non-sexually transmitted HIV, especially that transmitted through unsafe healthcare and cosmetic services, could be very high in many African countries.
The RethinkHIV researchers do list a few authors who dismiss non-sexual HIV transmission or claim that it is insignificant. But they don’t mention the research which recommends that non-sexual modes of transmission are in serious need of investigation. Adequate investigation into the relative role of non-sexual HIV transmission modes in the worst epidemics in the world has never been carried out; and funders and research institutions seem uninterested in addressing these and related issues.
However, out of the three papers published by RethinkHIV, one concludes that not enough is known about non-sexually transmitted HIV to evaluate prevention strategies in terms of cost, benefit, effectiveness, acceptability or anything else. Without alluding to the wealth of research already available, the short paper by Rob Baltussen and Jan Hontelez dismiss the rather lengthy claims made by Lori Bollinger in another paper as being without foundation.
Bollinger looked at issues such as autodisable syringes (ones that automatically break after one use and so can’t be reused), healthcare staff training in the proper use of syringes, safe disposal of medical waste and information for the public about non-sexual HIV transmission. The problem with her economic evaluation of these is that she availed of UNAIDS’ data on the different modes of transmission, which is woefully inadequate, being based more on assumption and guesswork than genuine research.
Baltussen and Hontelez’s questioning of UNAIDS’ data is brief and devastating and should be read by everyone interested in questioning the absense of funding for HIV prevention strategies that address non-sexual modes of transmission. It will be interesting to see whether this (inadvertently?) adversarial approach to what could be the biggest contributors to HIV transmission in African countries pays off.
This site provides information about non-sexually transmitted HIV and there are also links to various other related resources available on the web. In addition, you will find links to papers and sources of data used to create the site, throughout.
[I have have also covered these issues on my HIV in Kenya blog.]