AIDS in Africa - Letters - Letter to the Editor

I write in as one of the 'misguided' working on HIV/AIDS in Africa since the late 1980s (Currents, NI 359). Two points drew my concern.

First, many of us have always recognized the anal route in sexual transmission of HIV in Africa, and have long included it in educational and behaviour change messages for heterosexual couples, men having sex with men, sex workers and their clients and in work with street boys. True, more emphasis is needed on making it safer.

Second, the throwaway comment that unsafe medical practices 'probably caused most of the spread of HIV in Africa' is seriously misleading. Heterosexual sex, particularly between older men and younger women and between men and loosely defined sex workers or girlfriends, is only too clearly the major route of transmission, to judge by extensive data. The belated recognition that unsterile injections and other unsafe medical practices have also contributed more than previously recognized is no reason to throw out the baby with the bathwater.

Helen Jackson HIV/AIDS Advisor for UNFPA for Southern Africa, Harare, Zimbabwe

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