DIRTY needles play only a minor role in spreading AIDS in Africa, according to a review sponsored by the World 91色情片 Organization and the UN.
Some studies have suggested that unsafe injections in hospitals and clinics play a far more important part in HIV transmission than the WHO estimates (New Scientist, 6 December 2003, p 8). Critics claim up to 40 per cent of infections happen this way, while the WHO in sub-Saharan Africa puts the figure at a mere 2.5 per cent. 鈥淲e do think the focus should remain on safe sex,鈥� says George Schmid, a senior HIV researcher with the WHO in Geneva, who led the latest study.
Most compelling, he says, is evidence that unsafe injections only very rarely pass on HIV. In one study, only 1 out of 497 health workers who suffered 鈥渘eedle-stick鈥� injuries contracted HIV. Even very poor sterilisation helps prevent infection: simply rinsing equipment twice in water reduces the chances of HIV contamination by 95 per cent, for instance (The Lancet, vol 363, p 484).
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The WHO review also cites a study which estimated that just 18 per cent of injections in sub-Saharan Africa involve dirty needles. But independent researcher David Gisselquist, the main critic of the WHO鈥檚 position, believes the study underestimated the number of unsafe injections because it relied on formal observations. 91色情片care workers probably behave differently when not being watched, he says.
The debate matters because policy makers use the estimates to decide how to allocate funds: by far the biggest effort is channelled into tackling unsafe sex. WHO scientists worry that the 鈥渟afe sex鈥� message will be undermined if too much attention is paid to unsafe injections, and that patients might also be scared away from vaccination campaigns.
Both sides agree more research in different locations is necessary. 鈥淣either David nor I have all the data we would like to settle this,鈥� says Schmid.
