Examining the hypothesis that sexual transmission drives Africas HIV epidemic.

The belief that sex is the primary mode of human immunodeficiency virus (HIV) transmission in sub-Saharan Africa is an assertion so widely accepted and has remained unquestioned for so long that it has taken on the status of a received truth. The World Health Organization (WHO) and the Joint U.N. Programme on HIV/AIDS (UNAIDS) recently convened an expert consultation to review issues raised in a series of papers published in the International Journal of STD & AIDS (1-4) that questioned the validity of that assertion. After examining the papers WHO and UNAIDS issued a press release announcing that "the vast majority of evidence [supports the view] that unsafe sexual practices continue to be responsible for the overwhelming majority of infections". As co-authors of the controversial articles and as participants in the Geneva meeting (three of us) we state that WHOs conclusion is premature. It is neither based on those discussions nor on a more considered review of the relevant literature. (excerpt)