Dissident AIDS Database

EpidemiologyStatisticsHIVInconsistent figures
Africa isn’t dying of Aids
 Malan Rian
  "A year or so back, modellers produced estimates that portrayed South African universities as crucibles of rampant HIV infection, with one in four undergraduates doomed to die within ten years. Prevalence shifted according to racial composition and region, with Kwazulu-Natal institutions worst affected and Rand Afrikaans University (still 70 per cent white) coming in at 9.5 per cent. Real-life tests on a random sample of 1,188 RAU students rendered a startlingly different conclusion: on-campus prevalence was 1.1 per cent, barely a ninth of the modelled figure. ‘Doubt is cast on present estimates,’ said the RAU report, ‘and further research is strongly advocated.’ A similar anomaly emerged when South Africa’s major banks ran HIV tests on 29,000 staff earlier this year. A modelling exercise put HIV prevalence as high as 12 per cent; real-life tests produced a figure closer to 3 per cent. Elsewhere, actuaries are scratching their heads over a puzzling lack of interest in programs set up by medical-insurance companies to handle an anticipated flood of middle-class HIV cases. Old Mutual, the insurance giant, estimates that as many as 570,000 people are eligible, but only 22,500 have thus far signed up."
  The Spectator, 13 dec 20032003
Estimates on HIV called too high, New data cut rates for many nations
 Donnelly John
  The major error in the estimation of HIV and AIDS numbers has occurred primarily because epidemiologists relied too heavily on HIV rates in urban areas and failed to factor in much lower prevalence in rural areas, where surveys are rare, AIDS specialists said... Another reason behind the plunging rates, some AIDS specialists say, is that the pandemic may be slowing. The upcoming UNAIDS report is expected to show that HIV prevalence is declining in eastern Africa and leveling off or slightly slowing in West Africa, but still maintaining a high rate in southern Africa. More than a decade ago, AIDS researchers in sub-Saharan Africa found that HIV tests on blood samples from pregnant women at prenatal clinics provided a good indicator of HIV prevalence among adults aged 15 to 49 in countries with high rates; early household surveys confirmed the finding. But the surveys were limited at first to a few sites in countries. We were talking about four or five urban sites and one or two rural sites, and extrapolating that to the whole country. You can see what potential inaccuracies there can be with this crude methodology," said Chin, who now is an independent AIDS analyst and criticizes UN estimates as overstated. Other unknowns contribute to potential errors. One is estimating a country's population; the estimates for Nigeria, for instance, range from 120 million to 160 million estimating a country's population; the estimates for people, but a census of the country has not been completed in more than half a century... Rates also were lowered by a third in Zimbabwe because of significant numbers of faulty HIV tests. Several years ago, UNAIDS estimated that up to 60 percent of the Angolan military was HIV positive. Dr. Richard Shaffer, head of the US Department of Defense's HIV/AIDS Prevention Program, said in an interview the estimate was "nowhere near close to that. It's 6 to 7 percent. They based the earlier number on a small sample, which included people outside the military, and extrapolated that to the military as a whole.""
  The Boston Globe, June 20, 20042004
Evidence of iatrogenic HIV transmission in children in South Africa
 Brody Stuart, Gisselquist David, Potterat John J., Druckerb Ernest
  In December 2002, the Human Sciences Research Council (HSRC) of South Africa published results from a national census-derived random sample survey of HIV prevalence and selected risk factors in South Africans aged two years and older : a total of 8840 persons provided interview data and a specimen for the HIV test... (Shisana O et al, Nelson Mandela/Human Sciences Research Council Study of HIV/AIDS: South African National HIV Prevalence, Behavioural Risks and Mass Media: Household Survey. Cape Town: Human Sciences Research Council Publishers, 2002). The survey revealed a prevalence of 5.6% (131/2348) among 2–14 year olds, comparable to the 4.2% reported in Rwandan urban children in 1986 in the last national HIV serosurvey in Africa that included children (Rwandan HIV Seroprevalence Study Group. Nationwide community-based serological survey of HIV-1 and other human retrovirus infections in a central African country. Lancet 1989;1:941–943). Only 6.1% of the HIV-infected South African children had a dead parent, whether due to AIDS or any other cause... Neither the lay nor medical media seem to appreciate the HSRC report's implications: 5.6% of 2–14 year olds in South Africa would translate into an estimated 670,000 HIV-infected children, an inference not explicitly drawn in the report. This is 2.7 times larger than conventional estimates for vertically infected children between 0 and 15 years old, only about half of which would be 2 years or older. The conventional estimates are based on the proportion of women in antenatal sentinel surveys with HIV, on assumptions about mother-to-child transmission and neonatal survival and on presumed negligible HIV transmission through other routes (Joint United Nations Program on HIV/AIDS (UNAIDS). South Africa: Epidemiological Fact Sheets on HIV/AIDS and Sexually Transmitted Infections: 2002 Update. Geneva: UNAIDS, 2002).
  BRITISH JOURNAL OF OBSTETRICS & GYNAECOLOGY, Volume 110: Pages 450-452, May 2003.2003
President Mbeki might have a case on rethinking AIDS
 Stuart W Dwyer
  "In South Africa's prisons there is a vast overcrowded (often 30 people per cell) population in which homosexuality is widespread and condom use practically non-existent. This is the perfect breeding ground for the rapid spread of HIV. Sexually transmitted diseases are common in the prison where I work, and all prisoners who have any such disease are tested for HIV. Prisoners with any other illnesses that do not resolve rapidly (within one to two weeks) are also tested for HIV. As a result, a large number of HIV tests are done every week. This prison, which holds 550 inmates and is always full or overfull, has an HIV infection rate of 2-4% and has had only two deaths from AIDS in the seven years I have been working there. The HIV infection rate for all South Africa's prisons is currently 2.3%. The rate in the prison population should be higher than that in the general population, or at least the same. But the figures for prisons in South Africa are way below those generated by actuarial models and antenatal data, which purportedly reflect the incidence of infection in the general population"
  BMJ.com, BMJ 2002;324:237 ( 26 January )2002
Impact of highly active antiretroviral treatment on HIV seroincidence among men who have sex with men: San Francisco.
 Katz MH, Schwarcz SK, Kellogg TA, Klausner JD, Dilley JW, Gibson S, McFarland W
  Comment from David Rasnick : A study from the San Francisco Department of Public Health (SFDPH) reports a conclusion that is inconsistent with the SFDPH¹s own epidemiology. The March 2002 study states that the number of gay men testing HIV positive in San Francisco has doubled since 1996, rising from 2.1% in 1996 to 4.2% in 1999 even though SFDPH statistics actually show a decline in new HIV positive test results. The HIV Counseling, Testing, Referral and Partner Counseling and Referral Services (CTR/PCRS) report for 1999 noted 4,118 anonymous visits that year. From these visits, a total of 2,439 HIV tests were performed, 102 (or 4.2%) of which resulted HIV positive (www.dph.sf.ca.us, CTR/PCRS Reports,Data for 1999 by Behavioral Risk Population, page 11). In the CTR/PCRS report for 2000, researchers counted 4,526 anonymous visits, and 2,791 HIV tests of which 83 (or 3.0%) were designated positive (www.dph.sf.ca.us,CTR/PCRS Reports,Data for 2000 by Behavioral Risk Population, page 11). Despite the increase in anonymous visits in 2000 (up 10% from 1999) and the increased number of HIV tests performed (up 14% from 1999), the HIV rate, in fact, fell significantly there was no increase in the "blinded HIV rate". The data evidencing drops do not prevent Katz et al. from manipultaing data and claiming rises, or keep media from making alarming reports of a jump in "infection rates" allegedly resulting from increases in "unsafe sex", with "drug advances" blamed for the non-existent problem. Rather than investigating or discussing the claims about rising HIV rates made by the SFDPH study, the media simply repeated them.
  Am J Public Health 2002 92: 388-942002