I can’t answer the question in the title, and I don’t want an answer. What I want is that healthcare pros stop sliming suffering people with unsupported suspicions and accusations.
In a recent example of this reprehensible behavior, a senior member of Liberia’s Ebola Case Management Team speculated that a Liberian woman identified with Ebola in mid-March – several weeks after the last previous Liberian tested positive for Ebola – might have “had sex with a survivor” (http://abcnews.go.com/Health/wireStory/liberia-investigates-latest-ebola-patient-infected-29805278).
The infected woman has 5 children and a modest job – selling food in the market (http://www.gnnliberia.com/articles/2015/03/22/liberia-int%E2%80%99l-partners-visit-latest-ebola-victims%E2%80%99-home). Having Ebola is a heavy burden for the woman and her family and a threat to her neighbors. For her to be slimed in public – by a government official speculating about her sexual behavior – can only add to their sorrow and confusion.
What is the most likely source of her infection? Based on more than 20 Ebola outbreaks from 1976 to 2015, if the woman has not been caring for someone with Ebola (she hasn’t), she most likely got it from attending a healthcare facility that reused instruments without sterilization. Hundreds of cases of Ebola have been documented from unsafe healthcare, while no – none, nada, zero – cases of Ebola have been traced to sex with a survivor.
Is Liberia’s Ebola Case Management Team considering the possibility the woman got Ebola from a healthcare facility? Very likely, yes. Whereas the Ebola outbreak continues in Sierra Leone and Guinea, Liberia’s outbreak is over or nearly so. Such success is evidence that Liberia’s Ebola Team is competent – that it has recognized and addressed patients’ risks to get Ebola in hospitals and clinics.
Competent, yes, and that’s important. But the Team has been and continues to be unethical in not acknowledging such risks to the public.
A similar assessment applies to experts dealing with HIV in Africa. Consider, for example, that roughly 50% of married HIV-positive women in Africa – over 80% in the Democratic Republic of Congo and Sierra Leone – have HIV-negative husbands (data from Demographic and Health Surveys available at: http://dhsprogram.com/What-We-Do/survey-search.cfm?pgtype=main&SrvyTp=country).
Healthcare pros’ repeated assertions that sex is the source of almost all HIV infections in Africa charge all such women with extramarital sex, a charge that is a slur in many cultures. Such sliming is a de facto policy. Virtually all organizations that bankroll HIV prevention in Africa — UNAIDS, WHO, USAID, Gates, and others – require people they fund to aver that almost all HIV infections in Africa come from sex.
Many healthcare pros knowledgeable about HIV are aware of such nonsense. Those who speak out – who are both competent and ethical – have no chance to work on HIV in Africa. They are pushed aside in favor of others who are either ignorant or unethical (or both).