Transmission of HIV-1 infection in sub-Saharan Africa and effect of elimination of unsafe injections.
Schmid, George P;
Buvé, Anne;
Mugyenyi, Peter;
Garnett, Geoff P;
Hayes, Richard J;
Williams, Brian G;
Calleja, Jesus Garcia;
De Cock, Kevin M;
Whitworth, James A;
Kapiga, Saidi H;
+5 more...Ghys, Peter D;
Hankins, Catherine;
Zaba, Basia;
Heimer, Robert;
Boerma, J Ties;
(2004)
Transmission of HIV-1 infection in sub-Saharan Africa and effect of elimination of unsafe injections.
Lancet, 363 (9407).
pp. 482-488.
ISSN 0140-6736
DOI: https://doi.org/10.1016/S0140-6736(04)15497-4
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During the past year, a group has argued that unsafe injections are a major if not the main mode of HIV-1 transmission in sub-Saharan Africa. We review the main arguments used to question the epidemiological interpretations on the lead role of unsafe sex in HIV-1 transmission, and conclude there is no compelling evidence that unsafe injections are a predominant mode of HIV-1 transmission in sub-Saharan Africa. Conversely, though there is a clear need to eliminate all unsafe injections, epidemiological evidence indicates that sexual transmission continues to be by far the major mode of spread of HIV-1 in the region. Increased efforts are needed to reduce sexual transmission of HIV-1.