Medical practices not primary mode of HIV infection in Africa, UN meeting finds

Contrary to recent suggestions that a majority of HIV infections in sub-Saharan Africa are due to unsafe medical practices, an expert group convened by the United Nations reaffirmed today that unsafe sex remains the primary mode of transmission in the region.

Following a review of the evidence, experts convened in Geneva by the World Health Organization (WHO) and the Joint UN Programme on HIV/AIDS (UNAIDS) concluded that current epidemiological and biomedical data does not support the claim that the majority of HIV infections in sub-Saharan Africa are due to unsafe injections in healthcare contexts.

WHO previously estimated that unsafe injections account for only 2.5 per cent of HIV infections in the region. The meeting participants said today that while they fully agreed that safe medical injections are a crucial component of a comprehensive response to minimize the transmission of HIV, safer sex promotion must remain the primary feature of prevention programmes in sub-Sahara Africa.

The experts cited that age-specific infection rates, for example, strongly follow patterns of sexual behaviour and those of other sexually transmitted infections such as herpes simplex virus-2. In addition, children between 5-14 years, who are generally not yet sexually active, have very low HIV infection rates.

With approximately 3.5 million Africans infected by HIV in 2002 alone, discussions about other modes of transmission should at no time weaken the centrality of the safe-sex part of the response, the experts said.