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Interesting post from Dr. Handsfield for worrywarts
Occasionally, Dr. Handsfield posts a little synopsis on HIV epidemiology among the general population. He posted this today and I think it is worth reading:
This is off topic for this thread, and that question has been addressed several times. But it bears repeating, since it probably is the single least understood aspect of HIV epidemiology among the general population -- certainly among most people who ask questions on this forum. So here it is again.
I only "insist" on what the data support. The epidemiology of HIV and heterosexual transmission varies widely and your premise is not universally true. In the US and most industrialized countries, there is not a "large demographic" of heterosexually infected males. In 30+ years of the HIV/AIDS epidemic in the US, only a relative handful of men (a few thousand) have acquired HIV through heterosexual exposre -- in a country with something like 120 million heterosexually active males. Further, most men infected heterosexually were the spouses or other regular partners of infected women, not infected during casual, one-time partnerships. Similarly, most heterosexually infected women in the US were the regular partners of infected men, who usually acquired their infections from injection drug use or from sex with other men. Looked at another way, there is little sustained heterosexual HIV transmission in the US and, say, Western Europe. Instead, heterosexual transmission is sporadic and uncommon, usually the result of "bridging" from more high risk populations.
The situation is very different in much of the world, especially in some (but not all) developing countries. The reasons for the differences include differing sex partner networks, background rates of circumcision and other STDs, differences in sexual practices, stage of the HIV epidemic (which translates into the proportion of infected people who have high viral loads and thus are more efficient transmitters), and numerous other factors, not fully understood.
There are exceptions; i.e., there have been and will continue to be pockets of sustained heterosexual transmission in the US, and there is continuing fear that it could become much more common -- maybe just from the bad luck of a few people transmitting infection to a few others at just the wrong time and place. But until now, that hasn't happened, and sexual behavior experts really don't see much potential for it.
This is off topic for this thread, and that question has been addressed several times. But it bears repeating, since it probably is the single least understood aspect of HIV epidemiology among the general population -- certainly among most people who ask questions on this forum. So here it is again.
I only "insist" on what the data support. The epidemiology of HIV and heterosexual transmission varies widely and your premise is not universally true. In the US and most industrialized countries, there is not a "large demographic" of heterosexually infected males. In 30+ years of the HIV/AIDS epidemic in the US, only a relative handful of men (a few thousand) have acquired HIV through heterosexual exposre -- in a country with something like 120 million heterosexually active males. Further, most men infected heterosexually were the spouses or other regular partners of infected women, not infected during casual, one-time partnerships. Similarly, most heterosexually infected women in the US were the regular partners of infected men, who usually acquired their infections from injection drug use or from sex with other men. Looked at another way, there is little sustained heterosexual HIV transmission in the US and, say, Western Europe. Instead, heterosexual transmission is sporadic and uncommon, usually the result of "bridging" from more high risk populations.
The situation is very different in much of the world, especially in some (but not all) developing countries. The reasons for the differences include differing sex partner networks, background rates of circumcision and other STDs, differences in sexual practices, stage of the HIV epidemic (which translates into the proportion of infected people who have high viral loads and thus are more efficient transmitters), and numerous other factors, not fully understood.
There are exceptions; i.e., there have been and will continue to be pockets of sustained heterosexual transmission in the US, and there is continuing fear that it could become much more common -- maybe just from the bad luck of a few people transmitting infection to a few others at just the wrong time and place. But until now, that hasn't happened, and sexual behavior experts really don't see much potential for it.
Yes the reasons are more cultural than anything else.
I mentioned 'dry sex' already, which is practices in Sub Saharan Africa, particularly Natal region of ZA. Also it is very common for men to keep mistresses.
Prostitutes offer (unprotected) dry sex or they have no income.
Sistrust of Doctors. Some communities would prefer to see the witch Doctor.
Just google " dry sex HIV Africa" and pick any link which will explain.
Of course there are non-cultural reasons.
The shortage or HAART for the not so wealthy doesn't keep Viral Loads in check
Political reasons like some health minister's denying a problem exists. Lack of even basic education for some, let alone sex education.
Earlier in the epidemic condoms were not available.
I couldn't comment on Black British culture and infection rates among black British. .
There are quite a lot of infections in prisons here. The other factor with prisoners is the high number of injecting drug users and sex workers. One of the prisons here which is a prison for sex offenders has quite a large number of infections.
I mentioned 'dry sex' already, which is practices in Sub Saharan Africa, particularly Natal region of ZA. Also it is very common for men to keep mistresses.
Prostitutes offer (unprotected) dry sex or they have no income.
Sistrust of Doctors. Some communities would prefer to see the witch Doctor.
Just google " dry sex HIV Africa" and pick any link which will explain.
Of course there are non-cultural reasons.
The shortage or HAART for the not so wealthy doesn't keep Viral Loads in check
Political reasons like some health minister's denying a problem exists. Lack of even basic education for some, let alone sex education.
Earlier in the epidemic condoms were not available.
I couldn't comment on Black British culture and infection rates among black British. .
There are quite a lot of infections in prisons here. The other factor with prisoners is the high number of injecting drug users and sex workers. One of the prisons here which is a prison for sex offenders has quite a large number of infections.
Disregard "It's a different case in the UK" I meant to delete that as I re-read the article and noticed most of the infections were picked up overseas and diagnosed here.
(seems to tally exactly with what my GU clinic were saying "Hetresexual infection is reallly low risk, most of the people (male hereorosexuals) diagnosed are IDUs and Africans".
(seems to tally exactly with what my GU clinic were saying "Hetresexual infection is reallly low risk, most of the people (male hereorosexuals) diagnosed are IDUs and Africans".
It's a different case in the UK.
In 2006, heterosexual transmission accounted for 61% of those diagnosed in the UK. However, the overall risk of acquiring HIV through heterosexual sex **in the UK** remains relatively low. The majority of people diagnosed in the UK with HIV transmitted through heterosexual sex were actually exposed to the virus overseas, often in areas such as sub-Saharan Africa where it is more widespread.
Statistics
In 2006, there were an estimated 36,400 people aged 15 to 59 living in the UK who had contracted HIV through heterosexual sex. Of those 21,658 were women, and 14,742 men.
Those infected with HIV through heterosexual sex account for:
41% of all HIV cases overall in the UK
the highest proportion of newly diagnosed HIV cases in each year since 1999
59% of new HIV cases in 2005, up from 31% in 1996
49% of the total cases presenting for care, which is more than any other group (MSM now account for 42%)
Amongst people living with HIV who are heterosexual:
25% of women, and 38% of men, are unaware of their infection
many women are diagnosed by routine testing during pregancy
women aged 25 to 34 and men aged 30 to 39 are the groups most likely to be diagnosed
The number of people newly diagnosed with HIV from heterosexual sex in the UK rose from 156 in 1999 to 750 in 2006. Many of these were probably infected by partners exposed to the virus abroad.
In 2006, heterosexual transmission accounted for 61% of those diagnosed in the UK. However, the overall risk of acquiring HIV through heterosexual sex **in the UK** remains relatively low. The majority of people diagnosed in the UK with HIV transmitted through heterosexual sex were actually exposed to the virus overseas, often in areas such as sub-Saharan Africa where it is more widespread.
Statistics
In 2006, there were an estimated 36,400 people aged 15 to 59 living in the UK who had contracted HIV through heterosexual sex. Of those 21,658 were women, and 14,742 men.
Those infected with HIV through heterosexual sex account for:
41% of all HIV cases overall in the UK
the highest proportion of newly diagnosed HIV cases in each year since 1999
59% of new HIV cases in 2005, up from 31% in 1996
49% of the total cases presenting for care, which is more than any other group (MSM now account for 42%)
Amongst people living with HIV who are heterosexual:
25% of women, and 38% of men, are unaware of their infection
many women are diagnosed by routine testing during pregancy
women aged 25 to 34 and men aged 30 to 39 are the groups most likely to be diagnosed
The number of people newly diagnosed with HIV from heterosexual sex in the UK rose from 156 in 1999 to 750 in 2006. Many of these were probably infected by partners exposed to the virus abroad.
I posted that synopsis only for the purposes of reading-not for questioning the subject matter. If you have a question, bring it up with the doctor.
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