|
Home > Archive > HIV Aids > November 2005 > Lying About HIV In South Africa (by David Crowe, RedFlagsDaily.com)
You are viewing an archived Text-only version of the thread.
To view this thread in it's original format and/or if you want to reply to
this thread please [click here]
| Author |
Lying About HIV In South Africa (by David Crowe, RedFlagsDaily.com)
|
|
|
| From: Redflagsdaily.com
http://www.redflagsdaily.com/crowe.html
Lying About HIV In South Africa
By David Crowe
A recent paper in the journal AIDS is another torpedo into the
hull of HIV?Ts SS Sexual Transmission. (1)
The paper provides data from a large ?onationally representative?
2003 survey of 11,904 South Africans aged 15 to 24, who were chosen
randomly from households in each of the 2001 census enumeration areas.
Of the 15,414 young people identified by random selection, 77.2 percent
agreed to participate.
One of the authors is Nancy Padian, lead researcher on the famous 1997
study that estimated the risk of HIV transmission through heterosexual
intercourse to be about 1 in 1,000. (2) In that 10-year investigation, ?oNo
transmission occurred among the 25 percent of couples who did not use
their condoms consistently, nor among the 47 couples who intermittently
practiced unsafe sex during the entire duration of follow-up.? This left
Padian and colleagues to estimate the rate of transmission based on
patterns observed on entry into the trial.
The other authors are from major South African and American
institutions ?" university of the Witwatersrand in Johannesburg,
Development Research Africa, South Africa Medical Research
Council, Harvard University, university of North Carolina and
University of California.
It will be difficult to claim that this survey is amateurish or biased
by small numbers.
The data is quite incredible, but you would never know it from the
abstract or discussion sections of the paper. The conclusion in the
abstract reads: ?oThis survey confirms the high HIV prevalence
among young people in South Africa and, in particular, young
women?Ts disproportionate risk. Programs for youth must
continue to promote partner reduction, consistent condom use
and prompt treatment for sexually transmitted infections, while
also addressing contextual factors that make it difficult for them
to implement behavior change.?
In other words, it appears to confirm what ?oeveryone? already
knows and tells young South Africans to keep doing what they have
been told to do for years. It seems like nothing new or surprising was
discovered. That is far from the truth; the data is truly stunning.
Virgins and HIV
The most obvious conundrum is that a significant number of the young
people ?" 2.5 percent of the men and 3.8 percent of the women ?"
claimed never to have had sex, but are HIV-positive. For the men,
this is actually very significant, as only 5.9 percent of all males in the
survey were HIV-positive. More on gender differences later.
If we can assume that the percentage of virgin males, who became
HIV-positive (for reasons other than sexual intercourse), is the same
as the percentage of non-virgins, then this risk, whatever it is, may
be bigger than the possible heterosexual risk. The 2.5 percent who
were HIV-positive numbered 56 of 2,058 male virgins. If the same
pattern holds for non-virgins, 91 of the 221 HIV-positive non-virgins
(2.5 percent of 3,626) were infected non-sexually. This leaves only
130 men ?" 2.3 percent of the total ?" who might have been
infected sexually, slightly lower than the number infected non-sexually.
This is a bit awkward for the authors, so they just say, ?oA limitation
of all sexual behavior surveys rests in the nature of self-reported data.
In spite of rigorous training of interviewers and measures taken to
ensure privacy and reduce social-desirability bias, 2.5 percent of
men and 3.8 percent of women who reported never having sex
were HIV-positive. This has been found in other surveys of sexual
behavior in Africa.? So the authors are implying that these
respondents (and those in other surveys) were lying. Is it appropriate
for scientists to casually dismiss data that doesn?Tt fit within their
preconceived notions? Is acceptance of a priori reasoning a necessary
sacrifice for winning the war on an infectious virus?
Another possibility, perhaps the only other possibility that fits within
the infectious AIDS theory, is that these people were all infected by
their mothers, in the womb or by breastfeeding. Surprisingly, the
researchers do not raise this possibility. Mother-to-child transmission
(MTCT) of HIV is a major research topic, with AIDS workers all
over the continent promoting formula, cesarean sections, birth canal
disinfection at birth, and anti-retroviral drugs for HIV-positive
mothers to prevent the 25 percent rate of HIV transmission that
is believed to occur without intervention. (3)
The problem with the MTCT theory is that there is no evidence
supplied to show that these people, 15 to 24 years after infection,
are any sicker than average. It could lead down the slippery slope
of considering HIV as something that does not always result in
illness, let alone death, not even two decades later.
Figure 1, the HIV prevalence by age, at the time of the survey, lends
weight to the virgins telling the truth. The percentage of HIV-positive
male virgins (2.5 percent) is similar to the percentage of 15-year-old
boys who are HIV-positive (2.3 percent). Roughly, then, we should
be able to subtract this percentage from the graph, leaving a more
rapid and pronounced increase in presumably sexual transmission
with age, and a much larger gap between men and women.
This leads to the conclusion that sexual transmission becomes significant
for men around age 20, and for women around age 17. This would lead
to the conclusion that women are much more promiscuous than men, a
theory that will be dashed when we review other data in this survey.
Figure 1: HIV prevalence by age and sex among 15?"24 year olds,
South Africa, 2003 [Pettifor, 2005]
The only other explanation for these positive virgins that I can think of
is a high rate of false-positive test results. The researchers diagnosed
?oHIV infection? using a single rapid HIV test, a standard for
HIV testing that is much lower than in richer countries, where two or
three positive ELISA (enzyme-linked immunosorbent assay) antibody
tests must be followed by a positive western blot before a conclusion
is reached that someone is positive.
There is even a worse possibility for mainstream HIV researchers
who like to maintain a belief that HIV tests are almost completely
accurate. If we can question the accuracy of some tests, why not
the accuracy of all tests?
Either explanation, mother-to-son transmission or false-positive tests,
would mean that the rate of sexual transmission of HIV in males is
much lower than what the paper?Ts authors conclude. Dividing
the male sexual epidemic in half, and further emphasizing the
dramatically higher rate among women, is not a desirable conclusion
for people who are trying to persuade everyone that a deadly
epidemic is sweeping Africa driven by irresponsible male
sexual practices.
But, you will notice that I have so far neglected to talk much about
the females in this study. Their data is perhaps even more interesting.
Black Women: Immoral or Maligned?
The rate of HIV-positive tests among black women in this survey
was 23.3 percent. This dwarfs the rate in the three other gender/race
categories: black men (6.8 percent), non-black men (3.2 percent)
and non-black women (3.8 percent).
We can eliminate the possibility of this high rate of HIV prevalence
among black women being due to vagaries of small numbers because
the 88 percent of women (and 86 percent of men) surveyed were black.
The sexual transmission theory of HIV can only explain this by
concluding that black African women are highly promiscuous.
This, however, does not even fit with the racist view of black
sexual predators ?" men, of course ?" lusting after white
women. How could black women have a prevalence almost
four times that of black men?
Luckily, this survey included numerous questions related to
sexual habits. They provided enough raw data that some
additional analysis can be performed.
If this analysis shows that black women are less promiscuous
than men, then clearly we must reject the hypothesis that these
women became HIV-positive by sexual transmission.
To be as fair as possible, it is important to note that some
characteristics of women do indicate that they have slightly
more ?ounsafe sex? than men. One percent more of
the women surveyed have ever had unsafe sex than the men
(65 percent of women versus 64 percent of men) and the
women had slightly more sex too. Ten percent had sex
more than five times in the past month versus eight percent
of men. These differences are not great and can be at least
partly explained by women?Ts apparent preference for
slightly older men and more stable relationships.
Ninety-one percent of women had partners at least one year
older than themselves, and 38 percent had partners more than
five years older. By contrast, only 11 percent of men had older
partners and only one percent had partners more than five years
older. Only 13 percent of women were in a relationship less than
a month, versus 26 percent of men. This could explain the lower
usage of condoms at last sex by women (48 percent of women
versus 61 percent of men) and the greater likelihood of inconsistent
usage (73 percent of women versus 60 percent of men). This
data is not self-contradictory, as many partners of women
would be in the age range outside the limits of this survey.
HIV transmission should not come easily if you don?Tt sleep
around. You can have sex an infinite number of times with someone
who is HIV-negative and not contract HIV. Assuming that you
don?Tt know the HIV status of everyone, having multiple
partners is the best way to increase your odds. And here,
confirming common prejudices about gender differences,
women come up short in the sexual danger department.
The interviews with men indicate a strikingly higher level of promiscuity.
Twelve percent of males last had sex with a ?oregular casual
partner?o and five percent with a ?onon-regular casual
partner,? compared to less than one percent of females in
each category. Seventy-five percent of men had ever had more
than one sex partner, and 43 percent more than one in the past
year. By contrast, 58 percent of women had ever had more than
one partner and only 13 percent more than one in the past year.
Most importantly, 15 percent of men had sex before they were 15,
but only nine percent of females. This definitely does not fit with the
graph in Figure 1, which shows a steep rise in HIV prevalence
among women starting at about 17, but not until later for men.
Note that the 95 percent confidence intervals stop overlapping
at age 18, and stay that way until 24. If we were to accept that
all transmissions were sexual, we would have to conclude that
almost half of women who had sex by the age of 15 had become
HIV-positive (4.1 percent positive at age 15 versus nine percent
who had sex before this age) ?" but only 15 percent of men
(2.3 percent positive at age 15 versus 15 percent who had
sex before this age). What can explain the more than tripled
risk of transmission among women?
One can argue that significantly more women had been forced to
have sex than men. This was reflected in the survey ?" nine
percent of women said they had ever been forced to have sex
versus only two percent of men. Yet this fraction of women is
less than one-third of the women who are HIV-positive (19
percent of the total). And, remember, heterosexual intercourse
is only supposed to have a risk of HIV transmission of about
1 out of 1,000. (2)
Table 1: Sexual Experience of Young South African Males
versus females [Pettifor, 2005]
Promiscuity Characteristic Males (%) Females (%)
More than 1 sex partner ever 75% 58%
More than 1 sex partner in last year 43% 13%
Didn?Tt use condom at last sex 39% 52%
Doesn?Tt always use condom 60% 73%
Age of first sex &Mac178;14 15% 9%
More than a year since first had sex 74% 71%
Sex > 5 times in last month 8% 10%
Relationship length &Mac178; 1 month 26% 13%
Last sex was with regular casual partner 12% 1%
Last sex was with non-regular casual partner 5% 1%
Ever had transactional sex? 3% 2%
What could this possibly mean?
It is very difficult to explain these results through the heterosexual
theory of HIV transmission in Africa.
The theory can only be salvaged by assuming that women are not
only vastly more promiscuous than men, but also lie about it. To
distort the data in this way makes the survey unnecessary. Scientists
could just make up the numbers to match their preconceptions
and save the substantial cost of thousands of interviews.
The only way to make sense of these numbers is to jettison the
heterosexual theory, for both men and women.
If we assume that there is some reason why a higher percentage
of black women have false positive antibody reactions (at least on
rapid tests), perhaps fewer than five percent of South Africans are
genuinely HIV-positive. About half of these would have been
infected by their mothers (if we accept that those who claim to
be virgins aren?Tt lying), making heterosexual transmission
of HIV in South Africa a much smaller problem.
A bigger problem, considering the death sentence that goes
along with a positive HIV test, is distinguishing true positive-HIV
tests from false. This includes the possibility that all positive-HIV
test results are false positive.
If it is possible to lie by omission, then I think the problem with
dishonesty rests with these researchers, not their subjects. They
have deliberately ignored the sensational conclusions that should
be drawn from their data.
* * *
References:
Pettifor AE et al. Young people?Ts sexual health in South Africa.
HIV prevalence and sexual behaviors from a nationally representative
household survey. AIDS. Sept. 23, 2005; 19(14): 1525-1534.
Padian NS et al. Heterosexual Transmission of Human Immunodeficiency
Virus (HIV) in Northern California: Results from a Ten-Year Study.
Am J Epidemiol. August 1997. 146(4): 350-7.
Connor EM et al. Reduction of Maternal-Infant Transmission of
Human Immunodeficiency Virus Type 1 with Zidovudine Treatment.
N Engl J Med. Nov. 3, 1994; 331(18): 1173-1180.
| |
| Moira de Swardt 2005-11-23, 12:50 am |
|
"Alex" <avdeelen.REMOFETHIS1@wanadoo.nl> wrote in message
> Lying About HIV In South Africa
This is the third time you have posted this. I dealt with this
drivel the first time you posted it.
HIV is sexually transmitted. Get over it. Use a condom every time
you have sex.
--
Moira de Swardt
The most beautiful, most intelligent, most amusing, most charming,
richest, most talented woman currently posting to
soc.culture.south-africa
| |
| DavidT 2005-11-23, 10:49 am |
| Alex, let me give you a tip.
The article you post is so long that hardly anyone is going to bother
to read it.
Reposting it dozens of times will make people less likely to read it,
and also less likely to read your other other posts as well.
(so actually, I reckon you are doing a great job - keep it up)
| |
| monkey with four asses 2005-11-23, 12:49 pm |
| Moira de Swardt wrote...
> "Alex" <avdeelen.REMOFETHIS1@wanadoo.nl> wrote in message
>
>
>
>
> This is the third time you have posted this. I dealt with this
> drivel the first time you posted it.
>
> HIV is sexually transmitted. Get over it. Use a condom every time
> you have sex.
And you should wear a biohazard suit every time you go out in
public so you don't catch bird flu.
|
| |
|
|