Bloodborne HIV: Don't Get Stuck!

Given the flaws in UNAIDS’ Modes of Transmission model, the bulk of HIV transmissions in African countries are unexplained. They are not almost all, as UNAIDS claims, a result of heterosexual sex. Many must result from other modes of transmission, but UNAIDS has failed to take the necessary steps to investigate non-sexual transmission, through unsafe healthcare, cosmetic or traditional practices.

Another possible set of unexplained transmissions comes from research into women who have sex with women (WSW). A paper by Sandfort et al finds that “based on the available data [they] could not identify a transmission route for 13 of the infected women”, about a third of all infected women. The authors do admit that they “cannot rule out that these women were infected at birth or through medical procedures”, but they didn’t collect data that would allow them to rule out infection through medical procedures, for some reason.

A paper by Matebeni et al note that there are “some cultural practices in Southern Africa [which] render women’s bodies vulnerable and thus contribute to the spread HIV and AIDS” but they don’t say which ones, perhaps they are referring to female genital mutilation. This paper also mentions the possibility of expusure to medical transmissions, but they don’t make it clear what kind they are referring to.

Both papers give credence to the possibility that some of the women were infected with HIV through sex with their female partners. But if they haven’t tested the female sexual partners of the women they found to be HIV positive, we are as much in the dark about the risks of transmission through sex between women, particularly women who have sex exclusively with other women.

Both papers conclude that further research is needed and the authors are to be applauded for starting to address this highly sensitive subject. But it is to be hoped that they will consider non-sexual transmission if they do further research. Contact tracing would need to include, not just sexual contacts, but also contacts where the HIV positive person could have come into contact with someone else’s blood, such as various healthcare, cosmetic or traditional procedures.