AIDS in South Africa. A vicious cycle that is difficult to break.
A genetic study reveals how the virus spreads in this country, and why it is so difficult to stop. The recent International AIDS Society Conference, held in Durban last July, shed new light on the characteristics of this global epidemic.
By: Luis Pellegrini
South Africa, which recently hosted the International AIDS Conference, is one of the countries that has the most difficulty controlling the spread of the AIDS virus. According to a study presented in Durban, the event's host city, the root of this difficulty lies in a deeply rooted social phenomenon whereby young women frequently agree to have relationships with older men who, in exchange, pay for their studies, some meals, and other expenses.
Researchers at the Caprisa Centre (Centre for the AIDS Program of Research in South Africa) reconstructed the dynamics of contagion by analyzing the genetic characteristics of viruses circulating within a small community. This research concluded that the main critical point is precisely sexual relations between adult men and young women, often still in adolescence. Once infected, these young women, upon marriage, transmit the infection to their husbands and partners, who in turn will infect the young women with whom they have temporary relationships. "This is the engine that makes HIV so widespread in South Africa," comments Salim Abdul Karim, head of the study group. Interrupting this vicious cycle will not be easy, as it is fueled by the endemic poverty in the region.
Preventive medicine
Among the possible solutions, it was proposed to offer adolescent girls drugs that prevent the disease, already used in other countries. Indeed, although studies do not all agree on the effectiveness of this strategy, the World Health Organization recommends it for at-risk groups, and in June South Africa approved this form of prophylaxis for those who prostitute themselves, but not for all young women.
The International AIDS Conference also provided an opportunity for various discussions on the global aspects of the epidemic. According to the latest data, also published by the scientific journal Lancet, the number of people living with the virus worldwide is approximately 38,8 million (up from 27,9 million in 2005), and the number of deaths has fallen from 1,8 million in 2005 to 1,2 million in 2015. Even today, more than half of those infected do not have access to antiretroviral therapies. Although a clear reduction in mother-to-child transmission has been observed in recent years, the number of new infections among adults has fallen very little, remaining around 2,5 million per year. 72% of new cases occur in sub-Saharan Africa, and about 15,5% in South and East Asia. Western Europe accounts for 0,5% of new infections (about 13 per year).