Transmission of HIV-1 infection in sub-Saharan Africa and effect of elimination of unsafe injections.

Schmid, George P; Buvé, Anne; Mugyenyi, Peter; Garnett, Geoff P; Hayes, Richard J; Williams, Brian G; Calleja, Jesus Garcia; De Cock, Kevin M et al. · Lancet · 2004

review · Level V

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Abstract

During the past year, a group has argued that unsafe injections are a major if not the main mode of HIV-1 transmission in sub-Saharan Africa. We review the main arguments used to question the epidemiological interpretations on the lead role of unsafe sex in HIV-1 transmission, and conclude there is no compelling evidence that unsafe injections are a predominant mode of HIV-1 transmission in sub-Saharan Africa. Conversely, though there is a clear need to eliminate all unsafe injections, epidemiological evidence indicates that sexual transmission continues to be by far the major mode of spread of HIV-1 in the region. Increased efforts are needed to reduce sexual transmission of HIV-1.

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