The epidemiology of the acquired immunodeficiency syndrome in Africa
Imperato, P.J.
New York State Journal of Medicine 86(3): 118-121
1986
ISSN/ISBN: 0028-7628 PMID: 3458042 Document Number: 364783
The epidemiology of acquired immunodeficiency syndrome (AIDS) in sub-Saharan Africa is currently incompletely understood. Available data suggest a heterosexual distribution, with sexual promiscuity as the major risk factor. Homosexual/bisexual activity and intravenous drug abuse appear to play a minor role in AIDS transmission in Africa. Parenteral transmission also does not seem to be significant at present, but the widespread use of improperly sterilized, reused injection equipment in sub-Saharan African suggests that this may become a more important risk factor in the future. The paramedical personnel and traditional healers who provide much of the medical care in Africa lack training in the microbial causes of communicable diseases and the need to sterilize needles and syringes. The bidirectional heterosexual transmission pattern seen in Africa may be confounded by the medical reuse of unsterilized needles and syringes, as among prostitutes who receive frequent injections for sexually transmitted diseases. In addition, there may be cofactors such as concurrent sexually transmitted diseases and previous infections that enhance the likelihood of AIDS in Africa. Until a large body of well-designed epidemiologic studies has been accumulated, it is premature to come to any conclusions about the epidemiology of African AIDS or to extrapolate predictions regarding the future course of AIDS in Europe and the US from current trends in Africa.