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South Africa Continues to Fail to Reduce HIV Transmission


UNAIDS is strange, perhaps stranger than their numerous UN siblings. They have a single disease as their brief and they have spent 20 years learning next to nothing about it. They keep collecting data about sex, because they insist that HIV is almost always transmitted through unsafe sexual behavior in high prevalence African countries, but nowhere else. They have to shore up their arguments by appealing to prejudices, such as popular beliefs about ‘African’ sexuality, the brutish mentality of African men (yes, all of them) and the pathetic victim status of African women.

So it comes as a bit of a shock to them when they accidentally carry out research that casts doubt on their fondly held prejudices. A paper entitled ‘Sexual relationship power is unexpectedly not associated with unprotected sex in tavern populations in South Africa‘ is a case in point. Of course, alcohol abuse is a terrible social problem in South Africa (and many other countries), and needs to be addressed urgently. So is violence against women, gender based crime and a whole host of other social problems that are endemic in countries with a large proportion of very poor people who live in virtually uninhabitable environments.

UNAIDS is almost as old as South Africa’s epidemic, where prevalence stood at less than 1% in 1990 but rose rapidly to more than 25% over a decade ago and has not dropped below that figure since [I should clarify, these figures are for antenatal clinic attendees, not for the male and female 15-49 year old population, among whom prevalence is 18.8%]. The yearly HIV reports that South Africa shoves out are almost entirely about sexual behavior, with next to nothing about non-sexual transmission of HIV, via unsafe healthcare, cosmetic and traditional practices. I wonder how long it will take before anyone notices that they clearly haven’t even started to understand the worst HIV epidemic in the world.

[For more about sexual transmission risks and HIV prevention, have a look at some estimated risks from various sexual practices.]

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