AIDS fight drains health cash

Two medical experts have dared to challenge the long-held assumption that AIDS would eventually morph into a worldwide heterosexual epidemic.

Outside of sub-Saharan Africa, AIDS groups are wasting billions of dollars annually on programs directed at the general public, especially youth, who are at minimal to no risk of HIV transmission, argues James Chin, an epidemiologist at the University of California, Berkeley.

In a controversial paper he recently released, Chin claims massive amounts of money are being "squandered" by AIDS programs to prevent HIV infections in populations that are not at risk of epidemic transmissions.

In contrast, he says, millions of kids are dying each year of easily treatable diseases such as diarrhea, malaria, whooping cough and tetanus.

"Exaggeration of the potenial for HIV to spread into the general population is a glorious myth perpetuated by UNAIDS and most AIDS activists partly to avoid further stigmatization of persons with the highest levels of HIV risk behaviours," he writes in his report, The Myth of a General AIDS Pandemic.

Chin argues that HIV/AIDS will continue to have a disastrous demographic impact on sub-Saharan Africa and on gay men and injection drug users, but it will have "minimal to no" impact on most other populations.

"It is not possible for HIV to jump into any general population from these high-risk groups to spread in epidemic fashion in 'ordinary' people," he declares.


The major focus on preventing generalized HIV epidemics means there are fewer resources available to prevent HIV transmission in people with the highest risk behaviours, he adds.

He charges that "doom and gloom" AIDS activists have used this "myth" to gain a larger share of the global health budget at the expense of other urgent public health needs.

"I don't expect or forecast any significant heterosexual HIV epidemics in populations where such epidemics have not occurred," says Chin in his report.

Another epidemiologist and consultant to UNAIDS, Dr. Elizabeth Pisani, also questions the motivation of AIDS activists in a commentary in The London Times yesterday.

Effectively preventing the spread of HIV means spending money on "services for junkies, sex workers and gay men - groups that don't top the popularity stakes with voters," she writes.

Chin and Pisani have a point. There is certainly no evidence of a generalized HIV problem in North America, for instance. An estimated 60,000 Canadians are infected with HIV/AIDS. Of those, just over half are gay men, 17% are injection drug users, 12% are heterosexuals who come from countries where HIV prevalence is high in the general population and 4% are injection drug-using gay men.

In short, people in these high-risk groups account for more than 80% of HIV infections. And the greatest numbers of new infections continue to be among gay men.


And that worries Dr. Mark Wainberg, director of the McGill University AIDS Centre. He believes gay men's groups have dropped the ball on the safe-sex message.

"There's an attitude of complacency," he says. "No one should ever think that it's not a big deal to be HIV-positive. It is, and it is something to be avoided at all costs."

So are sexually transmitted diseases, for that matter, and the startling numbers show we face a complacency problem there as well. The heterosexual AIDS epidemic everyone feared hasn't come to pass. But chlamydia's a different story. Condoms are cheap. Life isn't.

CANOE -- Edmonton Sun: - AIDS fight drains health cash