Sex vs. Dirty Needles in AIDS Transmission
(Ivanhoe Newswire) -- A debate has been brewing over which is the major mode of HIV transmission in sub-Saharan Africa -- unsterilized needles or unprotected sex. Now, researchers from the World Health Organization conclude unprotected sex is the larger culprit.
A group of researchers proposed dirty needles are to blame for up to 40 percent of HIV-1 transmission. Other scientists worry this could take the attention away from preventive efforts focusing on safe sex. A closer look at both arguments is reported in The Lancet.
Researchers point out a number of flaws in the dirty needle theory. First, they note the reuse of needles is not as prevalent as some have assumed, and when needles are reused, the common practice is to wash and heat them, which destroys HIV. Secondly, they point to the low rate of HIV infection among children, who regularly receive injections but are not sexually active. Thirdly, they note use of injections appears to be no different among people who develop HIV and those who do not. And lastly, they believe the high rate of other sexually transmitted diseases in the region suggests HIV is also being sexually transmitted.
The investigators write, "The way in which Gisselquist and co-workers downplay the importance of sexual transmission could hinder efforts to control the sexual transmission of HIV-1 in sub-Saharan Africa." Specifically, they point to recent hearings on Capitol Hill aimed at determining whether more funds should go to preventing unsafe injections in the region.
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SOURCE: The Lancet, 2004;363:482-488