We are told that an estimated 44% of new HIV infections in Kenya occur among people who are in a ‘steady’ heterosexual relationship. In other words, the biggest contributing group to Kenya’s epidemic of roughly 1.6 million HIV positive people is made up of people who do not fall into any of the recognized HIV risk groups, what the HIV industry (currently) calls ‘most at risk’ people, or MARPs.
That might strike some readers as a sort of contradiction, those at lowest risk of being infected making up the largest group infected. That is unless readers are well primed to think that almost all HIV in African countries is transmitted through heterosexual sex. Some may think that that is true everywhere, though the HIV industry doesn’t even claim it about Western countries, and even many (non-African) developing countries. The exalted position of this paradigm means that many articles on HIV appearing in peer-reviewed journals do not even bother to say how they arrived at such an assumption. And so it remains just that, an unsupported assumption.
The ‘Modes of Transmission’ survey for Kenya is therefore the source of numerous headlines, such as ‘HIV spread ‘by wife swapping’ in Kenya – report‘. “HIV is being spread by “wife swapping” and infidelity according to a report in Kenya, where most new infections occur among heterosexual couples in stable relationships”, the article continues.
However, the modes of transmission survey simply collects data of mixed quality, which does not include systematic data about the HIV status of the partners of HIV positive people in stable heterosexual relationships. If someone is found to be HIV positive and they have no other identifiable risks, it is assumed that they had sex with someone outside of their ‘stable’ relationship. I’ve met people thus classified and they have said that they did not have a relationship with anyone but their partner, and some who said their partner was tested but found to be HIV negative; but how they are classified is not a matter of their own testimony.
Many people in Kenya (and Tanzania) I have asked have told me about how much infidelity there is in their community. They may even be right. But infidelity is not peculiar to Africans, nor to places where HIV prevalence is high. And so one can amuse onself indefinitely with articles based on ‘data’ that is little more than hearsay and gossip. Which may be fine for a newspaper, I guess. But when it is also the assumption that appears to lie behind numerous articles and widely cited reports, such as the Modes of Transmission survey, is that acceptable?
The implication seems to be that we all know what ‘Africans’ are like, sexually; hell, even African people themselves will tell you that Africans are promiscuous. And that’s not just an implication, many have written it or said it in some form or other. Is this how we analyse a HIV epidemic as serious as those found in some parts of some African countries? The dogs on the street know, so that’s good enough for UNAIDS and the HIV industry? One thing that is certain from 30 years of HIV: many promiscuous heterosexuals are not HIV positive, and many HIV positive people are not promiscuous. We are not entitled to publish glib titles like the Kenyan one above. So why are these titles so commonplace?