Why is AIDS a heterosexual disease in Africa?

Factual Questions
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[[The fact is that many well intentioned and otherwise sensible epidemiologists have colluded with politicians in international organizations, governments, and NGOs to make unconscionably inflated estimates of HIV prevalence in many countries (to say nothing of playing games with the numbers to mislead the numerically unsophisticated about current trends in disease incidence). ]]

Yeah (that’s his name), I am one of those state health department, CDC funded HIV/AIDS epidemiologists of whom you speak and I will tell you that we are in collusion with no one to exaggerate or inflate statistics. Others do it with our data all the time, but we have no such agendas. We collect and investigate data from a huge range of sources, including collecting all the HIV related lab results on patients in our state. We also do personal interviews and investigate transmission routes of those reporting no risk factors for infection. Our information is limited in one way by whether people voluntarily test for the virus, of course, so we have other kinds of population-wide seroprevalence studies going on to know more about true prevalence. It is an extraordinary surveillance system, and very secure and confidential. I think you’d be impressed if you knew more about it. Most of the rest of what we epidemiologists do is try to ferret out bias and limitations to the data. We want to know what’s really going on - the accurate picture. We also spend a lot of time educating those “numerically unsophisticated” persons, politicians and special interest groups who may tend to misuse the data. To say they we play into those games is misleading and totally inaccurate.

The biggest limitation to our surveillance system now is that many states still only count AIDS cases and not HIV. People are living longer with HIV and often not progressing to AIDS if they’re on medication. Those folks aren’t included in the numbers in states without HIV reporting and it’s important to know about them (to justify funding services for one thing). To get an idea of what kind of data we collect, go to http://www.cdc.gov/nchstp/hiv_aids/stats/hasrlink.htm
and download the 43 page HIV/AIDS Suurveillance Report. Show me where the CDC has put any kind of “spin” on any of this.
Jill

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“To say they we play into those games is misleading and totally inaccurate.” Jill

I suggest you read twice, reply once. I didn’t say that you “play into those games.” I wrote: “The fact is that many well intentioned and otherwise sensible epidemiologists…”
Notice I said many, not all. How many depends on the circles you run it. From your description, I would guess you are in a small to medium state with fairly well funded health department and a middling HIV problem (the Midwest?) where people have some respect for facts. In other circles (especially international circles) you will find that fact-citing epidemiologist have been largely displaced by epidemiologists of the sort I describe.

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[[Notice I said many, not all. How many depends on the circles you run it. From your description, I would guess you are in a small to medium state with fairly well funded health department and a middling HIV problem (the Midwest?) where people have some respect for facts. In other circles (especially international circles) you will find that fact-citing epidemiologist have been largely displaced by epidemiologists of the sort I describe.]]

Pretty unusual for true epidemiologists to be interested in much else besides facts. There are some “AIDS experts” out there who have some major agendas for sure, and I can’t speak for epidemiologists in most other countries (I’ve spent time with some in Mexico and Jamaica and know many who have worked in Africa, SE Asia and India, but not much direct experience other than that). I meet regularly with HIV/AIDS surveillance coordinators from all 50 states and U.S. territories. I have confidence in the national CDC driven surveillance system and seroprevalence projects being conducted in the U.S.

[[From your description, I would guess you are in a small to medium state with fairly well funded health department]] And no, my state health department is woefully under-funded! I do the job of several (when I’m not fooling around on the SD site - hah, your tax dollars at work)

Jill