AIDS in Africa: Disturbing Evidence
As a result of references in an online discussion, I recently came across two published articles which offer evidence that this explanation is wrong, that vaginal transmission rates in Africa are not substantially higher than elsewhere. They go on to suggest that what is really going on may be iatrogenic, doctor caused, disease, that much of the transmission may be due to sloppy medical procedures, in particular the reuse of needles for injections. The evidence is in part from the pattern of infection—rates are apparently much too high among young people who have not had sex and whose mothers are not HIV positive, suggesting a non-sexual transmission mechanism. In part it is from studies that try to measure the transmission rate via vaginal intercourse. In part it is from regional patterns that don't fit the patterns of the supposed causes.
The articles are:
Evidence of iatrogenic HIV transmission in children in South Africa
HIV infections in sub-Saharan Africa not explained by sexual or vertical transmission
My non-expert impression is that they represent serious scientific work, and that the evidence presented is pretty convincing. The implication is that this is a case of people trying to do good and doing harm instead, always disturbing. Does any reader know of later work either confirming or rebutting the argument?