Sowing the Seeds of Certainty part V – HIV and Unfalsifiability

16 Aug

A timely article has been published by John Potterat entitled ‘The Enigma of HIV Propagation in Africa‘. It’s available for download on the Social Science Research Network. Potterat goes back to the start of the HIV pandemic to figure out where the “time-honored Western view of Africans as promiscuous people” came from, and why it has continued to be assumed by so much discourse about HIV when there is overwhelming available evidence to show that it is false.

Potterat argues that “Despite mounting evidence suggesting a substantial role for nonsexual (puncturing) exposures in HIV transmission, researchers have not systematically investigated its impact on HIV propagation in Africa”. He concludes that “A science that ignores potentially important modes of transmission, especially when confronted by challenging and respectable evidence, is inadequate and needs remedial attention.”

When HIV was viewed as a problem for gay men and injecting drug users there was little interest in research and little funding. But when the “heterosexual scare” arrived a few years later, huge amounts of funding became available. High HIV prevalence in African countries was used as evidence that there was a similar threat to heterosexuals in Western countries. To questions about why Africa was, and continues to be, so disproportionately affected by HIV while epidemics in Western countries have remained confined to high risk groups, such as men who have sex with men and injecting drug users, discourse would revert to reflexes about ‘African sexuality’.

Potterat finds that even though “silent assumptions of African hyper-sexuality were challenged by results from multiple national surveys in the late 1980s and early 1990s showing that indicators of sexual activity in Africa were comparable to those reported in North America and Europe, where population-level heterosexual spread of HIV was not occurring”, myths about African sexuality continued to take on epic proportions.

The author continues “HIV was not infrequently diagnosed in persons denying sexual intercourse, as well as in persons reporting monogamous sex with an HIV negative spouse. Researchers generally discounted these findings by pointing out that there was something special about the way black Africans had sex, or that HIV diagnoses were not sufficiently accurate, or that respondents lied about their sex lives. Crucially, researchers failed to validate their speculations with proper scientific inquiry.”

To shore up older myths, newer myths were spun.”For 30 years, researchers and other observers have littered the epidemiologic landscape with armchair speculations about what might explain these epidemics: African sexuality, non-condom use, high genital morbidity and high STD burdens, lack of circumcision, HIV transmission-permissive tropical infections, polygamy, population migration and attendant prostitution, sexual concurrency, and age disparities between sex partners (older men coupling with very young women).” As a result, researchers still don’t know the real answer to the question ‘why Africa?’

So there isn’t just one myth about African sexuality; new myths are generated regularly and are as evidence-proof as anything that went before. Potterat says “Had defenders of the received wisdom attempted to falsify their assertion – that unprotected “heterosexual sex” accounts for virtually all HIV infections among sub-Saharan African adults…prevention efforts based on rigorous designs might well have had greater impact on efforts to stem rapid propagation of HIV infection.”

The use of these myths about HIV and ‘African sexuality’ is especially insidious because they are virtually unfalsifiable; evidence can be found to support all of them to some extent and you’ll always find people to assent to them. If your aim is to ‘prove’ your hypothesis, all you need to do is collect up the bits of evidence that support your contention and discard the bits that don’t. You could object that this is just not science, I certainly would. But it is the state of the art in the field of HIV. It is this shoddy version of science that is used to dehumanize Africans and beat HIV positive people and their families into submission.

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5 Responses to “Sowing the Seeds of Certainty part V – HIV and Unfalsifiability”

  1. Paddy O'Gorman November 6, 2013 at 5:12 pm #

    You could add rampant child sex abuse to another myth made up against Africans… that HIV+ men rape children (virgins) to rid themselves of HIV. If child sex abuse could spread Aids then it would be spreading in my country (Ireland) too. No wonder people are scared of black men driving taxis when this racist rot is put about.

    • Simon Collery November 7, 2013 at 8:46 pm #

      Hi Paddy, good to hear from you. Yes, you’re quite right, the extent of infant rape is often assumed rather than proven, as is the cause of infections in infants. Yet this short paper from Nigeria shows that out of 22 HIV positive children, whose mothers were also tested, the probable mode of transmission from mother to child was only 63.6% but that the mode of transmission for group circumcision was 22.7%. While unscreened blood accounted for 4.5% of transmissions, which the authors consider to be very low, a further 9.1% of transmission was attributed to sexual transmission, two girls who were believed to have been sexually abused and were believed to have signs of sexually transmitted infections. But we are not told if intimate partners of mothers were tested or if anyone had been charged with sexual abuse. So while that number of sexual abuse cases is very worrying, it doesn’t show that the HIV was transmitted sexually; such transmission is probably not particularly common. Sometimes media reports concentrate on the horrific nature of the crime, which is possibly understandable, but without researching the issue of HIV transmission under such circumstances, which can give a very dangerously misleading impression. As for accidental transmission in hospitals, this is not generally sexy enough for media reports, unless it happens in ‘enemy’ territory, such as Libya. But if you attribute something terrible to black Africans, people will probably have heard it all before and be unsurprised. I find the BBC to be particularly bad in this respect.

Trackbacks/Pingbacks

  1. The Media in Africa: Beware of Natives | Blogtivist - November 3, 2013

    […] sexuality is a trusty tool in the journalist’s store of prejudices. Although it has been debunked many times, the media picture of Africans has remained faithful to their apartheid agenda. Africans are truly […]

  2. Journalist Follows ARV Breadcrumb to Source of Chickenshit | Blogtivist - November 7, 2013

    […] A comment on a blog post I wrote a few months back reminded me about the HIV ‘virgin cure’, the myth that if you have sex with a virgin you will be cured of HIV. With sensationalist media reports, it’s hard to know how often this has really happened, as opposed to how often a case of child sexual abuse was attributed to the ‘virgin cure’. But when HIV is found in children whose mother is not HIV positive in African countries , it can be left implied that the child must have been abused. There are many ways a child could have been infected  (such as unsafe ‘group’ circumcision, contaminated blood transfusion and perhaps others), unfortunately, but they haven’t attracted media attention quite like the ‘virgin cure’ myth. […]

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