HIV/AIDS in Africa

A co-author and I responded to an editorial in Trends in Microbiology [1]. The editorial was entitled: Patient 0’ and the Origin of HIV/AIDS in America. In the editorial, Gong et al praised the work of Woroeby et al [2].

The story dispelling the Patient Zero myth was a media meme not long ago. The conclusions of a phylogenetic analysis performed by Worobey et al captured that media accalim [2].

Worobey also concluded that HIV migrated to the USA from Africa via Haiti. Gong et al support this concept by listing three “plausible scenarios” for HIV transmission from Haiti to the USA.

See my full response to Gong et al below. It describes the epidemiological winds that blow HIV from the United States towards the Caribbean (excluding Cuba because American travelers and tourists were embargoed).

Haiti got all the press, but 5 years into the AIDS epidemic (1986), it was Bermuda that had the highest AIDS rate in the world, as seen in Table 1.

 

Table 1:          AIDS Prevalence in United States and Caribbean as of September 1986

Country

Prevalence

(cases per 100,000)

Reported AIDS cases

Population

Bermuda

76.3

42

55,000

Bahamas

30.5

68

223,000

United States

10.3

24,169

234,249,000

Trinidad/Tobago

9.4

108

1,149,000

Haiti

8.8

501

5,690,000

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Patient Zero did not introduce HIV into the United States!

Not too long ago, this story was a meme cascading through the media. All emanating from a phylogenetic analysis published in Nature, 1970s and ‘Patient 0’ HIV-1 genomes illuminate early HIV/AIDS history in North America [1].

The authors of this phylogenetic analysis (Worobey et al) also concluded that HIV migrated to the USA from Africa via Haiti. However, extensive epidemiological evidence suggests the Africa-Haiti-USA historical narrative is just as incorrect as the narrative regarding Patient Zero.

Stuart Derbyshire and I wrote a Letter to the Editors of Nature in response to conclusions of Worobey et al. At the kind invitation of the Editors, our response is posted on the Nature website. Given the allowance of 300 words and 3 references, the response cites a limited portion of available epidemiological data refuting this concept. The response with the full complement of 13 references is rendered in text, below.

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[Continued from HIV / AIDS Statistics in South Africa: and the Possible Implications for the Treatment and Diagnostic Industries (Part 1)]

As described in Part I of this article, few people realize that the familiar HIV/ AIDS global statistics are actually estimates. For example, UNAIDS estimated that the Republic of South Africa had 140,000 HIV / AIDS deaths in 1997 [1]. However, after tabulating all death certificates for 1997, the Republic of South Africa attributed only 6,635 deaths to HIV / AIDS [2].

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The situation with the African HIV / AIDS epidemic is analogous to that of the global finance crisis. Thousands of diligent people are investing money, effort, heart and soul into a false conceptual paradigm, while a small number of people aware of the situation are unconscionably reaping financial and professional rewards. Relative to HIV / AIDS, the false operative paradigm is that HIV / AIDS is devastatingly epidemic in Africa.

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blog_logoRoger England is Chairman of the Health Systems Workshop, Grenada.  His analyses and commentaries are lightly sprinkled through the scientific literature.  The Writing is on the Wall for UNAIDS was England’s editorial in the British Medical Journal (BMJ), May 2008.  England criticizes the rampant “exceptionalism” granted to HIV/AIDS across many domains.

In one strong statement, England writes: Continue reading

blog_logoAs principal investigator at the Harvard School of Public Health, Max Essex, was recently awarded $20 million to study HIV prevention in Botswana – a meager reward for the man who played a pivotal role in creating the current conceptual model of the HIV / AIDS epidemic, compared to the billions distributed annually [1].

Essex’s erroneous research spawned the theory that HIV originated in African monkeys. This misconception is critical because the concept is a pillar for the fallacy that HIV / AIDS is endemic in Africa. Continue reading

blog_logoHIV/AIDS statistics in South Africa (and Botswana) are entirely implausible.  Given the known rates of HIV sexual transmission during vaginal intercourse, the purported current rates of HIV prevalence among the heterosexual adults of these countries exceed all plausible limits of human sexual activity.  In this video presentation, Chris Jennings explains why the statistics for HIV/AIDS prevalence in South Africa are entirely implausibility (with mention of Botswana and New York City).

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blog_logoThe first Africans diagnosed with AIDS were two white gay men who lived in the Republic of South Africa [1]. (The Republic of South Africa is typically referred to as “South Africa.”)  As was typical for every AIDS case outside the United States early in the AIDS epidemic, both of these South African gay men caught AIDS in the United States.

Both of these men were gay male air stewards (flight attendants) who had visited the United States before the development of their disease [1], and both died from Pneumocystis carinii pneumonia (PCP), a classical early-onset opportunistic infection secondary to HIV infection.

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blog_logoWill Solimene Award from American Medical Writers Association (AMWA) Recognizes the Innovative Research, Definitive Analytics, and Scientific Conclusions challenging HIV/AIDS Statistics in South Africa

Cambridge, Massachusetts, U.S.A.:  The book HIV/AIDS in South Africa by Chris Jennings was awarded the 2014 Will Solimene Award for Excellence in Medical Communication. The Solimene Award recognizes outstanding work in medical, biomedical, and health communication published during the previous two years.

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