Bloodborne HIV: Don't Get Stuck!

Perhaps the author means well by speculating about how much ‘sodomy’ there is in Zambian prisons. But articles like this miss a great opportunity to look at possible non-sexual HIV risks in prisons. For example, what are safety standards like in prison health facilities? Do prisoners engage in cosmetic practices, such as tattooing, piercing, even shaving and hairdressing? Do any of them engage in traditional practices that may involve skin piercing or cutting? Do any engage in blood oaths or anything else that could result in a HIV negative person coming into contact with the blood of a HIV positive person?

The article says that “homosexuality is among the six key drivers of the transmission of HIV in” Zambia. One source lists these drivers as: multiple and concurrent sexual partners, mother to child transmission, low and inconsistent condom use, vulnerable and marginalized groups, low rates of male circumcision and mobility and labour migration. Let’s look at each of them in turn.

No non-sexual ‘drivers’ are clearly identified there. But the list is a very weak tool for identifying the risks that many people face, given that prevalence reaches over 20% in the capital, Lusaka, and close to that figure in two other provinces. For example, several articles have shown that having multiple partners does not account for extremely high rates of HIV transmission; concurrent partnerships are no higher in high prevalence areas than in low prevelence areas, but they can not account for very high rates of transmission either, despite the frequent, triumphalist literature spewed out on the subject.

Many women are infected fairly late in their pregnancy or just after giving birth, when they are unlikely to have engaged in any kind of sexual behavior, let alone unsafe sexual behavior; and the partners of many women who seroconvert are HIV negative. In addition, some women are infected by their infant, who could only have been infected by some kind of non-sexual route, such as unsafe healthcare. We have no idea how common this phenomenon is.

HIV prevalence in many countries is higher among those who sometimes use condoms and lower among those who say they never do. Condom use only protects against sexual transmission of HIV, not against non-sexual transmission. The issue of circumcision is highly controversial and it has never been shown that the mass male circumcision programs currently being carried out in high HIV prevalence African countries will have any impact on HIV transmission, except by the use of dubious figures conjured up by those who believe that circumcision is superior to the alternative, which involves not slicing off a healthy piece of genital flesh.

Mobility and labor migration are perhaps more closely related to ‘vulnerable and marginalized groups’ in Zambia because HIV prevalence is exceptionally high among those involved in mining, for example. Many miners are mobile, many are immigrants, and high levels of HIV prevalence means that they are singled out for stigmatization by the HIV industry, which insists that HIV is almost always transmitted through unsafe sex. Therefore these high prevalence groups must be promiscuous, also careless, selfish, predatory and a whole lot of other pejorative things.

The HIV industry continues to stigmatize people who are often already marginalized, blame people who are infected and alienate people who are most vulnerable to suffering from poor health, facing many other hazards relating to health, poverty, education and employment. There are two ‘drivers’ of HIV epidemics, sexual and non-sexual. The industry concentrates on sexual transmission to the almost total exclusion of non-sexual transmission. This needs to be addressed if countries like Zambia are to reduce HIV transmission, especially in prisons and mining areas, and eventually eradicate it altogether.

[For more about non-sexually transmitted HIV through unsafe healthcare, cosmetic and traditional practices and how to protect yourself, visit the Don’t Get Stuck With HIV site.]