A new study reported in the Washington Post (6 April) drastically redefines the extent of the AIDS epidemic in Africa.
The new data suggest the rate never reached the 30 percent estimated by some early researchers, nor the nearly 13 percent given by the United Nations in 1998.
The study and similar ones in 15 other countries have shed new light on the disease across Africa. Relying on the latest measurement tools, they portray an epidemic that is more female and more urban than previously believed, one that has begun to ebb in much of East Africa and has failed to take off as predicted in most of West Africa.
Yet the disease is devastating southern Africa, according to the data. It is in that region alone — in countries including South Africa, Botswana, Swaziland and Zimbabwe — that an AIDS Belt exists, the researchers say….
Years of HIV overestimates, researchers say, flowed from the long-held assumption that the extent of infection among pregnant women who attended prenatal clinics provided a rough proxy for the rate among all working-age adults in a country. Working age was usually defined as 15 to 49. These rates also were among the only nationwide data available for many years, especially in Africa, where health tracking was generally rudimentary.
The new studies show, however, that these earlier estimates were skewed in favor of young, sexually active women in the urban areas that had prenatal clinics. Researchers now know that the HIV rate among these women tends to be higher than among the general population….
In West Africa, Sierra Leone, just then emerging from a devastating civil war, was found to have a national prevalence rate of less than 1 percent — compared with an estimated U.N. rate of 7 percent.
Such disparities, independent researchers say, skewed years of policy judgments and decisions on where to spend precious health-care dollars.
“From a research point of view, they’ve done a pathetic job,” said Paul Bennell, a British economist whose studies of the impact of AIDS on African school systems have shown mortality far below what UNAIDS had predicted. “They were not predisposed, let’s put it that way, to weigh the counterevidence. They were looking to generate big bucks.”
Prevalence of male circumcision correlates with lower rates of AIDS.