Wednesday, February 23, 2011

Lit in Review: HIV/AIDS

De Walque reports in third person on his own research:
The pervasive if unstated belief in the HIV/AIDS community is that males are primarily responsible for spreading the infection among married and cohabiting couples.... most couples affected by HIV/AIDS in sub-Saharan Africa live in ... relationships in which only one of the two partners is HIV-positive while the other one is HIV-negative.
Contrary to assumption, however, it is not the case that the HIV-positive partner is most often the male. In fact, a new study found that women were just as likely to be the HIV-positive partner. An earlier study had placed the figure closer to 30-40%. When the same is restricted to women who have been in one relationship for 10 years (reducing the chance of her bringing HIV with her into the union), the proportion is still roughly 1 in 3. Though I don't agree when de Walque calls this "just as likely" I would agree that it calls the basic assumption into question and supports better research into the channels by which AIDS spreads. Ignoring one apparently significant channel by assuming it does not exist not only prevents progress, it serves to further the victimization of women.

Topping this off is another paper (Leclerc et al, 2009) that tried to fit Zambian HIV infection data with epidemiological models and demonstrated just how difficult a task it is to model: "Our reference simulation (H0) was obtained after more than one hundred simulation trials, all the others leading to inconsistent patterns." They find that "the lifetime risk of infection is quite similar for both sexes, and women tend to be infected earlier." "Among the main constraints found in the simulation was the age at peak infection for males. It was almost impossible to reach values greater than 35 or 36 years for men while keeping the main parameters within a range of realistic values."

Another paper, also by de Walque and colleagues, shows that HIV households in Mozambique were not affected more than non-HIV households by the 2007/08 food crisis, perhaps thanks to increased health interventions that increased their labor force participation.

Meanwhile, there is actually good news from Zimbabwe: HIV infection rates halved between 1997 and 2007.
The study cites increased awareness of AIDS-related deaths as the primary cause of the drop. The Leclarc study also reports a drop (or at least a slowing) in infection rates in Zambia since 2001.

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