Monday, September 17, 2012

The Travels of AIDS

As a health care professional who worked in San Francisco hospitals in the 1980's when gay men first were admitted with a mystery disease, I thought I knew something about AIDS. Daniel Halperin and Craig Timberg's book, Tinderbox: How the West Sparked the AIDS Epidemic and How the World Can Finally Overcome It adds so much more.  They describe how genetic studies have traced the virus to equatorial forests in Cameroon, how and when the virus was likely transmitted to humans, and more importantly, how it was transported to the colonial city of Leopoldsville. There it was free to break out and spread widely, carried to Haiti by returning Haitian temporary workers and then to the US via the gay community which vacationed in Haiti.

The book's primary focus is Africa, however, where heterosexual AIDS has been overwhelmingly disastrous.  The West contributed by opening Africa to new colonial cities and blazing routes through areas which never before had been connected. Missionaries discouraged polygamy but instead new patterns of multiple sexual partners developed, which fostered rampant spread of the virus.

The authors then describe how Western AIDS groups have focused on preventions which proved ineffective while not supporting more accurately targeted homegrown efforts. Halperin is a very strong advocate of circumcision, which has been shown to decrease HIV transmission by 60%, but was not initially supported by the aid groups. Africans have been open to it, since it was and still is practiced by some tribes. Reading reviews of this book on Amazon, I was amazed to see vigorous attacks by anti-circumcision advocates. Just the facts, folks.

Because patterns of sexual contacts are so different in Western countries from those in Africa, heterosexual AIDS epidemics there never have been likely. This is clearly illustrated. And there's so much more.  It's a fascinating book, despite the undertone of West bashing and the sense of crusading by Halperin. Read it and learn.

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