International Journal of STD & AIDS > Volume 20, Number 7 > Pp. 443-446

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How to contain generalized HIV epidemics? A plea for better evidence to displace speculation

D Gisselquist PhD ^* , J J Potterat BA , J S St Lawrence PhD , M Hogan JD , N K Arora MD ^**, M Correa PhD , W W Dinsmore MD , G Mehta MD , J Millogo MD MSc ^***, S Q Muth BA , M Okinyi BA  and T Ounga MSc 

^* Hershey, PA 17033; Colorado Springs, CO 80909; Mississippi State University, 1000 Highway 19 North, Meridian, MS 39307; P.O. Box 643, Burtonsville, MD 20866, USA; ^** International Clinical Epidemiology Network, 18 Ramnath Building, 3rd floor, Yusuf Sarai, Community Centre, New Delhi 110049; 1016, Muddo, PO Carona, Bardez, Goa 403523, India; International Journal of STD & AIDS, Department of Genito-Urinary Medicine, Royal Victoria Hospital, Grosvenor Road, Belfast BT12 6BA, UK; Lady Hardinge Medical College, New Delhi 110001, India; ^*** Retractable Technologies, Inc, 511 Lobo Lane, Little Elm, TX 75068; Quintus-ential Solutions, 1013 East Las Animas St, Colorado Springs, CO 80903-4519, USA; Safe Healthcare Africa, P.O. Box 11039 (00100), Nairobi; Tropical Focus for Rural Development, P.O. Box 6443 (40103), Kisumu, Kenya

Correspondence to: Dr D Gisselquist Email: david_gisselquist{at}yahoo.com

In the worst generalized HIV epidemics in East and Southern Africa, from one-quarter to three-quarters of women aged 15 years can expect to be living with HIV or to have died with AIDS by age 40 years. This disaster continues in the face of massive HIV prevention programmes based on current inexact knowledge of HIV transmission pathways and risks. To stop this disaster, both the public and public health experts need better information about the specific factors that allow HIV to propagate so extensively in countries with generalized epidemics. This knowledge could be acquired by tracing HIV infections to their source – especially tracing HIV infections in women of all ages, and tracing unexplained HIV infections in children with HIV-negative mothers.

Key Words: HIV infections • acquired immunodeficiency syndrome • risk assessment • epidemiologic methods • contact tracing • Africa

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