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

Int J STD AIDS 2009;20:443-446
© 2009 Royal Society of Medicine Press


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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}

In the worst generalized HIV epidemics in East and SouthernAfrica, from one-quarter to three-quarters of women aged 15years can expect to be living with HIV or to have died withAIDS by age 40 years. This disaster continues in the face ofmassive HIV prevention programmes based on current inexact knowledgeof HIV transmission pathways and risks. To stop this disaster,both the public and public health experts need better informationabout the specific factors that allow HIV to propagate so extensivelyin countries with generalized epidemics. This knowledge couldbe acquired by tracing HIV infections to their source –especially tracing HIV infections in women of all ages, andtracing unexplained HIV infections in children with HIV-negativemothers.

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

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