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).

Video Transcript:

By current estimates, 17% of adults in the Republic of South Africa have HIV/AIDS.  In Botswana, 25% of the population supposedly has HIV infection. These numbers entirely implausible.  They exceed all feasible limits of human sexual activity.

Now, to put things in proper perspective, we need to examine the sexual behavior of gay males in NYC at the beginning of the HIV/AIDS epidemic.

At the beginning of the AIDS epidemic, the gay men in New York City averaged approximately 20 different sexual partners every 6 months [ref] [ref], or by another account, they averaged approximately 1000 sexual partners over their lifetime [ref].

Now, in truth, these numbers represent only gay males who were highly sexually active.  Not all gay males are highly sexually active.  But at the other extreme, the Centers for Disease Control tracked one gay male who claimed 750 different sexual partners over a 3-year period [ref].

This level of sexual activity among gay males, in a limited geographical areas, gave rise to the geometric growth in the number AIDS cases in the United States at the beginning of the HIV/AIDS epidemic.  Geometric means doubling in number every six months [ref].

Now, the risk of HIV transmission during unprotected anal intercourse is estimated to be 0.005–0.02 per exposure.  The estimated risk for HIV transmission during vaginal intercourse is 0.001 per exposure [ref] [ref] [ref]. What this all means is the risk of HIV transmission during unprotected anal intercourse is approximately 5 to 20 times greater than the risk of HIV transmission during unprotected vaginal intercourse.

Unprotected means without a condom.  Also these numbers I am citing represent the risk to the receptive partner.

The HIV/AIDS epidemic in Africa is said to be heterosexual.  So for the heterosexual African men to match the same HIV transmission rates as the gay men in New York City, the average African heterosexual man would require approximately 100 – 400 different sexual partners every 6 months.

Now unlike the AIDS epidemic in Europe and the United States, wherein men predominate — in Africa, supposedly the number of men infected with HIV is equal to the number of women affected with HIV.

So African heterosexual women would be required to be extraordinarily busy to infect an equal number of men, since the transmission rate – female-to-male – is approximately 1.1 to 3.3 times less efficient than HIV transmission from male-to-female.  So the females would be required to have approximately 110 to 1200 different sexual partners every 6 months in order to accomplish this rate of HIV transmission.

Now all this extraordinary sexual activity among the heterosexual males and females of Africa would only give them a transmission rate comparable to that found among gay males in New York City.  But current prevalence of HIV in New York City is approximately 0.4%, or four-tenths of one percent; whereas, in South Africa, the current estimate for HIV prevalence is 17% of all adults, and in Botswana 25%.

Therefore, in order to achieve this astronomical rate of HIV infection in the general population, the heterosexual African men of South Africa would require approximately 4200 to 17,000 sexual partners every 6 months; while females would require approximately 4700 to 51,000 sexual partners every 6 months.

These astronomical numbers are based on the concept that New York City and South Africa have similar size populations of highly sexually active individuals in both.  But we must account for the fact that there are far more numbers of heterosexuals than homosexuals.  The difference in HIV prevalence in New York City – which is four-tenths of one percent – and South Africa – which is supposedly 17 percent – is a multiple of 42.

Meaning, that for every gay male New Yorker having 20 different sexual partners every six months, there must be 42 South African heterosexuals having comparable sexual activity in terms of HIV transmission rates.  So, for every gay male New Yorker having 20 different sexual partners every six months, there must be 42 South African heterosexual males having 100 – 400 different sexual partners every six months, or 42 heterosexual females having 110 – 1200 different sexual partners every six months, or a combination of the two.

Although these numbers are absurd to the extreme, I want to caution my viewers against thinking they have witnessed a valid quantitative statistical analysis.  Rather, this presentation should be considered qualitative in nature.

The difference?  Well, most of you are familiar with quantitative scoring in school.  Perhaps you got a 97 in your last test, or an 85 as a final grade.  This is a method of quantitative scoring.  The method of qualitative scoring would be A, B, C, or D – they give general grades or, perhaps qualitatively, you have a “pass/fail” score.

With sufficient quality, you pass the course.  If the quality of your work was insufficient, then you fail the course.  And this is the way to view this presentation.

After viewing this material, do you believe the concept of an HIV/AIDS epidemic among African heterosexual males and females that achieves a 25% prevalence rate among the population – do you believe this concept passes?  Or do you believe this concept fails?

Obviously, this presentation raises many issues.  Not the least of which is the conclusion that the HIV antibody tests are simply invalid among tropical, indigent populations.

One of the major fallacies is that poverty is related to HIV/AIDS in Africa.  Far more likely is the conditions secondary to poverty in Africa give rise to an extraordinary number of false-positive outcomes in the HIV antibody test.

But that’s another story for another time.

Related Blogs:

Bibliography

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Havens, P.L. (2003) Postexposure Prophylaxis in Children and Adolescents for Nonoccupational Exposure to Human Immunodeficiency Virus. Pediatrics 111: 1475-1489.  [PMID: 12777574]

Pinkerton, S.D., Martin, J.N., Roland, M.E., Katz, M.H., Coates, T.J., and Kahn, J.O. (2004) Cost-Effectiveness of Postexposure Prophylaxis after Sexual or Injection-Drug Exposure to Human Immunodeficiency Virus. Arch Intern Med 164: 46-54.  [PMID: 14718321]

Smith, D.K., Grohskopf, L.A., Black, R.J., Auerbach, J.D., Veronese, F., Struble, K.A. et al. (2005) Antiretroviral Postexposure Prophylaxis after Sexual, Injection-Drug Use, or Other Nonoccupational Exposure to Hiv in the United States: Recommendations from the U.S. Department of Health and Human Services. MMWR Recomm Rep 54: 1-20.  [PMID: 15660015]

Szmuness, W., Dienstag, J.L., Purcell, R.H., Harley, E.J., Stevens, C.E., and Wong, D.C. (1976) Distribution of Antibody to Hepatitis a Antigen in Urban Adult Populations. N Engl J Med 295: 755-759.  [PMID: 183113]

Szmuness, W., Much, I., Prince, A.M., Hoofnagle, J.H., Cherubin, C.E., Harley, E.J. et al. (1975) On the Role of Sexual Behavior in the Spread of Hepatitis B Infection. Ann Intern Med 83: 489-495.  [PMID: 1166979]

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