How did researchers fail to find what’s driving Africa’s HIV epidemics?
October 11, 2011
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HIV is not an easy virus to catch – it needs memorable skin-piercing events or intimate sexual contact. So it shouldn’t be too hard to find out why people living in city X have 50-100 times greater risk for HIV than people living in city Y. How? Find people with new infections and ask them about recent skin-piercing events (injections, tattoos, accidents) and sex partners. Then go look for the source. See if the people who gave the injections or other skin-piercing procedures reliably use sterile instruments; test others who visited the same clinic. Trace and test sex partners. Then sequence viruses to look for matches and therefore linked infections.
Over the past 30 years, international and foreign organizations have funded a lot of research on HIV in Africa. This research includes 44 randomized controlled trials testing interventions to prevent HIV among adults. How did these studies fail to explain what is different about HIV in Africa? As crazy at it seems – they didn’t ask, didn’t look, and didn’t report what they found. The details of this failure are documented in a review available on this website at: https://dontgetstuck.wordpress.com/downloads/ and from the Social Science Research network at:
Only 5 of the 44 studies reported recent sexual risks for people with new HIV infections (having any vs. no sex partner, or less than 100% condom use). Only 5 of 44 studies reported recent injections in people with new HIV infections. No study – not one! – traced any HIV infection to any non-primary partner or blood contact. When experts say that non-primary partners account for most HIV in Africa – How do they know? They never looked! Less than 5% of more than 4,000 new infections observed in these 44 studies were traced to spouses that were already enrolled and followed in the studies. Otherwise, no study traced any infection to any other source.
What is the chance that foreign-funded researchers in Africa will overcome decades of incompetence to finally do what they should have done long ago – trace infections to find their source? More likely, African governments and the African public will lead the way.