Monday, February 05, 2007

Expert says it is only in sub-Saharan Africa, where unprotected sex outside marriage is common, that the risk of heterosexual HIV transmission is high

BBC News:

HIV/Aids campaigners are circulating "misconceptions" about who is at risk, a former World Health Organization expert has warned.

Dr James Chin was head of a WHO Global Programme on Aids unit from 1987-1992.

In a new book, he says people in the general population outside Africa are unlikely to contract HIV/Aids, as it is restricted to certain high-risk groups.

Campaigners have promoted a message of safer sex which involves the use of condoms for protection.

UK experts said Dr Chin's views were inaccurate, and misrepresented current thinking among HIV/Aids bodies.

Dr Chin says HIV prevalence is low in most populations throughout the world and can be expected to remain low.

He believes this is not because of effective HIV prevention work, but because infection rates are limited by the numbers in groups whose behaviour puts them at high risk.

Dr Chin says it is only in sub-Saharan Africa, where unprotected sex outside marriage is common, that the risk of heterosexual HIV transmission is high.

In other parts of the world, he says HIV is seen only in men who have sex with other men, intravenous drug users and female sex workers.

And he says that, unless the clients or partners of people in these groups also indulge in high-risk behaviour, the virus will not spread.

However Dr Chin says these facts have been "minimised and ignored" by UNAids and Aids activists because it is "politically and socially more acceptable" to say HIV risk behaviours are present in all populations.

Writing in "The Aids Pandemic", Dr Chin says: "These activists do not want to further stigmatise persons or population groups who have such high risk levels of HIV risk behaviours and who are already marginalised.

"By refusing to accept the fact that HIV is very difficult to transmit sexually without the highest levels of sexual risk behaviours, Aids programmes have avoided labelling some populations as being more promiscuous than others.

"It is a much more socially and politically correct public health message to say that sexual promiscuity exists in all populations and thus the risk of epidemic heterosexual HIV transmission to the general public, or to ordinary people can be prevented only by aggressive programmes directed at the general population, and especially to youth."

He cited studies which showed the risk of someone in the general population of contracting HIV from any single sexual act was, at the highest estimate, one in 1,000.

And he says the failure to recognise this means that scarce public health resources in countries where HIV prevalence is low are being wasted on prevention programmes being targeted at the public, when it is the high-risk groups who should be targeted.

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