Originally posted by whodey
In the article it states that 67% of all AIDS cases globally originate from Saharan Africa. This comes out to be about 23 million people.
Conversely, if you take the entire bulk of North Africa PLUS the Middle East together, there are only about 1.5 million cases.
So what is it about Saharan Africa ...[text shortened]... Is it merely poverty? If so, why not other poverty stricken areas?
What is your explanation?
Sadly the link is dead, whodey... Not that I'm contradicting you: what you say is an empirical fact. Can you track it back down?
(One interesting thing to note - since there is a grinding inevitability that you will bring this up at some point, somehow - is that homosexuality probably accounts for a tiny percentage of HIV infections in this area.)
Part of the explanation is cumulative (although we do need to explain how we got to this stage). It seems likely that the sheer prevalence of HIV-1 (largely genotype C, from memory) in sub-Saharan Africa means that a 'tipping point' has been passed - epidemiologically speaking, the sheer number of people infected, and the unusually large number of women infected and certain cultural practices in that area, means that re-transmission rates are extraordinarily high. Even if promiscuity rates were low (which in many areas they are, comparatively speaking), the effect of high-volume infection is not arithmetic, but more exponential.
You speak about 'poverty' as a cause, but poverty itself
has no real bearing on the matter - it is the effects
of poverty that are a major cause.
Unsafe blood transfusions (which accounted for a shocking number of HIV infections before immuno-assay testing became available in the west) accounts for part of this process. Poverty leads to dreadful medical care - and where that is available, it is incredibly sub-optimal by western standards. Where 'life-saving' transfusion is available, the historical western pattern of transfusion-related infection is a contemporary reality.
Similarly, the lack of (inexpensive by western standards) clean needles for many basic medical procedures and similarly (again, by our standards) inexpensive sterilisation equipment means that yet more basic medical procedures carry high risks of transmission.
See, again, the cumulative effect above for why this is important.
(Again from memory, transmission by blood is higher than any form of sexual transmission. If I am mistaken here, the risk from blood is still high, although their lack of access to pooled products somewhat reduces that risk and if I am mistaken about relative risk this is because of pooled product risk.)
But obviously, sexual transmission is still the most common disease vector - but this, too, can be linked to poverty.
Poverty breeds prostitution, and prostitution - especially absent safe sex - breeds all STDs, including AIDS, for example.
The effects of poor education are cumulative, too. Poor general
education leads to poor sexual
education and an inability to break with (pseudo-) traditional ways of life and social practices and also makes sub-Saharan Africa ripe for AIDS denialism.
And then, of course, there is the root cause of the AIDS pandemic, which most certainly started in Africa - it is a legacy of colonialism and the effects that practice had on African life. That sub-Saharan Africa feels these after-effects most acutely is also vitally important.
There's probably more to be said, but that is the start of my explanation...
(apologies for all the edits: closing off italics in multiple places...)