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Healthcare, not heterosexual sex, implicated in spread of HIV in Africa, according to new research

Women in sub-Saharan Africa who receive tetanus injections as a preventative healthcare measure are twice as likely to subsequently test HIV-positive as women who do not, according to a new study published in the Royal Society of Medicine’s International Journal of STD & AIDS.

The study, which is based on evidence from Kenya, found that tetanus injections put women at risk of HIV infection, but that measures of ordinary sexual behaviour such as condom use and number of partners were unrelated to later HIV infection status.

“Healthy, pregnant women are being put at risk of HIV when receiving unsafe healthcare for themselves and their unborn child,”

said senior researcher Professor Stuart Brody of the University of Paisley. His co-author was Eva Deuchert of the University of Freiburg in Germany.

“These are serious and troubling results not only for Kenya, but for many other places with potentially unsafe health practices.

“Our findings are part of a growing body of evidence which demonstrates that the focus by authorities and health organisations on sexual behaviour in the African sub-Sahara as a way of curbing the spread of HIV is misguided,”

said Professor Brody.

Professor Brody’s study showed that Kenyan women who received prophylactic tetanus toxoid injections during pregnancy were 1.89 times more likely to be HIV positive than women who did not receive this vaccination. In contrast, recent sexual behaviour was not related to HIV status. The injections were preventative measures not related to any HIV-related illness and none of the women reported being HIV positive. Consequently, the results were unlikely to be due to HIV-infected women seeking these purely preventive injections.

“The World Health Organisation claims that unsafe injections are uncommon in sub-Saharan Africa,”

said Professor Brody.

“However, along with the Joint United Nations Programme on HIV/AIDS, they recommend to their own employees to avoid injections in sub-Saharan Africa.

“It is time for the WHO and their collaborators to acknowledge the extent of unsafe health practices, such as multiple use of inadequately sterilized medicinal equipment as well as other unsafe punctures, and increase resources to tackle the problem as a matter of urgency,”

he said.

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The role of health care in the spread of HIV/AIDS in Africa: evidence from Kenya [PDF 79k]

‘The role of health care in the spread of HIV/AIDS in Africa: evidence from Kenya’ by E Deuchert & S Brody is published in the November 2006 issue of the International Journal of STD & AIDs.

IJSA is published monthly by the Royal Society of Medicine. Its Editor is Professor Wallace Dinsmore.