Cheap Solutions Cut AIDS Toll for Poor Kenyan Youths

NY Times ^ | August 6, 2006 | CELIA W. DUGGER

[neverdem]

At a time when millions of people each year are still being infected with the virus that causes AIDS, particularly in Africa, a rigorous new study has identified several simple, inexpensive methods that helped reduce the spread of the disease among Kenyan teenagers, especially girls.

In Kenya, where poverty drives some girls to sleep with older men for money or gifts, teenage girls are seven times more likely to be H.I.V. positive than boys the same age.

The new study found that when informed that older men are much likelier to be infected, teenage girls were far less likely to become pregnant by so-called sugar daddies.

The $1 million study, financed by the Partnership for Child Development, a London-based nonprofit group, did not seek blood tests for H.I.V., since its subjects were minors. Instead, it relied on pregnancy as evidence of unprotected sex.

The study found that when girls in impoverished rural areas were given free school uniforms instead of having to pay $6 for them — the principal remaining economic barrier to education in Kenya — they were significantly less likely to drop out and become pregnant.

Researchers also found that classroom debates and essay-writing contests on whether students should be taught about condoms to prevent the spread of H.I.V. increased the use of condoms without increasing sexual activity.

The methods, identified by economists affiliated with the Poverty Action Lab at the Massachusetts Institute of Technology, offer a splash of good news in an often bleak landscape.

--snip--

In Kenya, large-scale surveys based on H.I.V. blood tests have found that infection rates, at less than one-half of 1 percent among teenage boys, rise to 7 percent among men 25 to 29, and peak at 9 percent among those 40 to 44.

[neverdem]

That last sentence in the excerpt means laboratory evidence. So much for the claim that these diagnoses in Africa are just presumptive diagnoses based only on clinical presentation, i.e. appears ill, malnourished, fever, etc.

[Brad from Tennessee]

I read a prediction, probably by the World Health Organization, about 10 years ago that said AIDS--if unchecked--would take out 50 percent of the world's population by 2040.

[Brad from Tennessee]

This is a link about how circumcision may cut the HIV rate by 60 percent. This is not new. There was an article in Scientific American last year on the same issue:

http://news.independent.co.uk/uk/health_medical/article1217831.ece

[ElderEdda]

So, abstinence works? Hmmm /sarc

[dsc]

"So much for the claim that these diagnoses in Africa are just presumptive diagnoses"

Yes. Or rather, no.

Firstly, Kenya is just one country on a huge continent, and not the poorest. A statement about Kenya cannot be generalized to the entire continent.

Secondly, even here they are not claiming to have tested all suspected patients, but merely to have made a "large scale survey," which is rather vague.

All this tells us is the rate of infection among the sample (of unknown size and composition) that they *selected* (based on criteria unknown to us).

In other words, it tells us only that there is some unknown number of cases in Kenya.

The fact remains that countries in Africa simply do not have the money to do the testing that would be required to confirm their claimed infection rates.

[conservative in nyc]

That last sentence in the excerpt means laboratory evidence. So much for the claim that these diagnoses in Africa are just presumptive diagnoses based only on clinical presentation, i.e. appears ill, malnourished, fever, etc.

Well, not exactly. Until the new millennium (or in some cases, the late 1990s), the UN-favored methodology for obtaining AIDS rates in Africa was to use AIDS rate from so-called sentinel testing of pregnant women who visited health clinics as a proxy for the country's rate. National random voluntary blood or saliva testing is a fairly new phenomenon.

The problem with the old methodology is that most clinics are in urban areas, where the AIDS rate is higher, pregnant women are at a higher risk of getting AIDS since they obviously haven't been abstinent or used condoms, and African women tend to be more at risk for AIDS than African men for some reason. So the AIDS rate in many African countries was overstated, often by a factor of about 1.5x-2x, and in Sierra Leone's case, by a factor of 7x.

More info here:
How AIDS in Africa Was Overstated (Washington Post, Craig Timberg 4/6/06)

[conservative in nyc]

The methodology for the 2003 Kenya survey is discussed here. I don't know if there was a more recent survey. The 2003 survey was a voluntary household survey of a large sample of the Kenyan population.

According to the Washington Post story I linked in my prior response, these new national surveys (most done by ORC Macro of Maryland) have shown that AIDS rates in most African countries were much lower than the UN has historically been reporting based on so-called sentinel surveys of preganant women.

[neverdem]

I made that comment because if I don't read that HIV is a harmless virus, ala Duesberg, then I get comments that the prevalence of HIV/AIDS is overestimated because of the lack of HIV serology, and that the real numbers are obscured by TB, malaria, etc. Kenya has some real numbers, now.

[Rocco49]

I am constantly amazed at what escapes the obvious. If 6 bucks keeps kids from getting an education in Kenya, why in the heck don't they allow kids to wear whatever they can to school. A million bucks would have saved the lives of 166,000 girls, but put some lame researchers out of a cushy job.

[conservative in nyc]

I get comments that the prevalence of HIV/AIDS is overestimated because of the lack of HIV serology, and that the real numbers are obscured by TB, malaria, etc. Kenya has some real numbers, now.

Well, the official UNAIDS numbers from the pregnancy sentinel model WERE historically overestimated because of the lack of HIV serology in many cases, and ARE obscured by TB, malaria AND pregnancy (which sometimes causes false positives), since the UN methodology sometimes allowed for a single positive ELISA blood test to be determinative. The ORC Macro/USAID Kenyan methodology required a second test to limit false positives.

The UNAIDS agency has likely been overstating the African AIDS rate for years, in part to justify its own funding.

[dsc]

"The methodology for the 2003 Kenya survey is discussed here."

Thanks for the link. I think the discussion there shows that there are indeed problems with the sampling.

"these new national surveys (most done by ORC Macro of Maryland) have shown that AIDS rates in most African countries were much lower than the UN has historically been reporting based on so-called sentinel surveys of preganant women."

Which reflects favorbly on the methodology, but I don't think it's reliable yet.

[dsc]

"I get comments that the prevalence of HIV/AIDS is overestimated because of the lack of HIV serology, and that the real numbers are obscured by TB, malaria, etc. Kenya has some real numbers, now."

If the new, lower numbers are closer to correct, then it seems that it was indeed the case that the real numbers were previously obscured.

[KeepUSfree]

Yeah, and they also said that 1 in 10 americans would have it by 2001.

It's lies to get more money.

[PeterPrinciple]

In Kenya, large-scale surveys based on H.I.V. blood tests have found that infection rates, at less than one-half of 1 percent among teenage boys, rise to 7 percent among men 25 to 29, and peak at 9 percent among those 40 to 44.


These percentages are no where near what we are told in other media. We are told half the population has aids and send more money.

I still stand by my opinion and observation that a lot of what people think is aids is caused by other things like malnutrition.........unfortunately there is no longer money for malnutrition, only AIDS.

[neverdem]

If the new, lower numbers are closer to correct, then it seems that it was indeed the case that the real numbers were previously obscured.

I thought the point was noteworthy not for the true prevalence of HIV/AIDS in Kenya, but for the fact that they have now positive HIV serology for Duesberg et al. and their fellow deniers.

BTW, once they have adequate lab support, they can also rule out the other diagnoses with similar symptoms.

[neverdem]

These percentages are no where near what we are told in other media. We are told half the population has aids and send more money.

Not even the NY Times claims such numbers.

I still stand by my opinion and observation that a lot of what people think is aids is caused by other things like malnutrition.........unfortunately there is no longer money for malnutrition, only AIDS.

Where's the malnutrition in South Africa?

Circumcision Studied in Africa as AIDS Preventive

"According to a study Mr. Halperin published in 1999, seven southern African countries, where fewer than one in five men were circumcised, had H.I.V. prevalence rates in adults of 14 percent to 26 percent in 1998. In nine western African countries, where more than four in five men were circumcised, H.I.V. prevalence rates were below 5 percent."

[dsc]

I don't know of anyone who said there was *no* AIDS in Africa; it was those ridiculous and unsubstantiated numbers that were contested.

[neverdem]

I don't know of anyone who said there was *no* AIDS in Africa;...

I've encountered more than a few. I was going to link the posting history of David Allen, but he's been banned or suspended. I'm a doc. I've posted more than a few articles on HIV & AIDS. Look up Duesberd or Peter Duesberg as a key word.

[dsc]

"I've encountered more than a few."

Takes all kinds to fill up a freeway, I guess.