n South African Journal of Child Health - HIV prevention - what's new? : hot topics




Since its identification in the 1980s, the prevalence of infection with the human immune deficiency virus (HIV), the cause of acquired immune deficiency syndrome (AIDS), has increased relentlessly in spite of concerted efforts to curb its spread. The majority (> 90%) of people infected with HIV live in low- and middle-income countries. Poverty, migration and their consequences are plausible explanations for the rapid spread of a disease that is mainly transmitted sexually and through contact with blood. However, they seem inadequate as explanations for the strikingly disproportionate burden of the epidemic in sub-Saharan Africa (which is home to only 10% of the world population yet accounts for over 60% of infected people). More data are needed to elucidate variables for disease spread, particularly those relating to behaviour. What specific behaviours, cultural or otherwise, make sub-Saharan Africans, or any other people, more susceptible to infection? Even though the magnitude of benefit from circumcision is debatable, the lower HIV prevalence and seroconversion rates (adjusted risk reduction of about 60%) in circumcised cohorts illustrates this point.


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