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Scientific/Medical Question 29
Why do you think HIV/AIDS is more prevalent in Africa than Europe or North America?
This is a difficult question - the obvious answers of higher rate of injectable drug use, or more promiscuous behaviour, are seemingly not correct. A study in Botswana found that the average citizen has sex with between 1 and 3 people a year; hardly a big enough difference from America to justify a population having 33% infection rate vs 1% in the US. Most Africans with AIDS claim not to use drugs, nor have large numbers of sexual partners.
One theory that explains the prevalence is that of concurrent partners. This may allow the spread of disease through a population much more quickly. However, the most part of the literature now states that concurrent relationships are not more common in African than elsewhere.
Some traditional practises like widow inheritance and sexual cleansing have been found to increase the likelihood of HIV transmission.
Another possible factor is male circumcision - several studies have suggested that it protects both men and their partners from infection with HIV; it is not practised in southern or eastern African countries.
It seems likely that gender norms, and especially the male view of sex, may be the real cause of the increased prevalence of HIV in Africa. The idea that men ‘already’ know about sex and don’t need to be told more about it, normalisation of multiple concurrent sexual partners, and homosexuality being driven underground, and therefore entirely untested, may all be social factors that are contributory.