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Comment by umvi | Hacker News Reader

Yeah, I probably could have phrased my original comment better. I didn't mean to imply the areas in Africa with HIV issues have a culture of rape. I said "if there is a rampant culture of rape/unprotected sex with many partners the same region will just get ravaged by the next STD and stick them back in the same rut." (emphasis added).

My point being, if we have a magic pill that cures them of a given STD, but there are underlying cultural problems that contribute to elevated STD transmission (such as unprotected sex or rape), etc., then the magic pill is only a bandaid that doesn't address the underlying elevated STD transmission problem.

As a sibling comment stated, maybe the problem is that these Africans believe homeopathic cures like special tea leaves will protect them from HIV when in reality they are just all having unprotected sex, so it's both a cultural and educational issue.

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Double yikes to "these Africans." Pretty sure misplaced belief in homeopathy is not a distinctively African phenomenon.

But to the point: the major driver of the early explosion of HIV on the continent was almost certainly large-scale vaccination and medical treatment campaigns by colonial governments, which injected staggering numbers of people in rural areas without adequate disinfection of needles.

In the present, the sociological drivers of HIV spread do include rates of nonconsensual sex (particularly between teen girls and older men). More important factors, however, are historical and contemporary patterns of urban/rural migration and long-distance transit networks. The distinctive forms of cyclical migration created by the shape of the mining industry in apartheid South Africa are the largest reason that the pandemic is so much worse in that region than anywhere else on the continent.

Research is pretty clear that Africans understand that condoms work to prevent HIV transmission - there have now been decades of public education campaigns on the subject. That doesn't mean they are always used, of course, but it's not a knowledge problem.

>But to the point: the major driver of the early explosion of HIV on the continent was almost certainly large-scale vaccination and medical treatment campaigns by colonial governments, which injected staggering numbers of people in rural areas without adequate disinfection of needles.

Colonial governments were mostly out of Africa after the 1960s.

>In the present, the sociological drivers of HIV spread do include rates of nonconsensual sex (particularly between teen girls and older men). More important factors, however, are historical and contemporary patterns of urban/rural migration and long-distance transit networks. The distinctive forms of cyclical migration created by the shape of the mining industry in apartheid South Africa are the largest reason that the pandemic is so much worse in that region than anywhere else on the continent.

That's being very disingenuous. What makes periodic migration by miners in South Africa different from large-scale worker migrations elsewhere in the world? Mexican farm workers to the US, half of China, or for that matter Canadian, Russian, and Australian miners, or oil-rig workers everywhere. It's not so much the migration patterns, but what the migrants do (or don't do) when "back home".

> Colonial governments were mostly out of Africa after the 1960s.

HIV was probably spreading in the Belgian Congo in the 1920s. It likely spread to the US in the 60s. It takes a decade for HIV to turn into AIDS, which is why we think of the pandemic as starting in the 80s.

> It takes a decade for HIV to turn into AIDS

The median time is a little longer than that, but the range goes down to less than a year. We think about it as starting in the 1980s because that's when the diverse manifestations were recognized as a common syndrome, not because that's when symptoms first appeared in the US (in fact, there is a case retroactively identified as a death from full-blown AIDS in the US in 1969.)

I don't think it's particularly helpful to "yikes" everything, because I'm not intending to offend, be racist, etc.

I admit I am not an expert. I formed an opinion after scanning the official wiki on the topic (https://en.wikipedia.org/wiki/HIV/AIDS_in_Africa) which says things like: "High-risk behavioral patterns are largely responsible for the significantly greater spread of HIV/AIDS in Sub-Saharan Africa than in other parts of the world. Chief among these are the traditionally liberal attitudes espoused by many communities inhabiting the subcontinent toward multiple sexual partners and pre-marital and outside marriage sexual activity." and don't mention anything about migration patterns being the more important factors.

So if this is actually your field of study, it would be helpful if the wikipedia article were updated with the latest research.

It's okay, everyone expresses an ignorant opinion at some point. We aren't born knowing everything and we have to keep learning as the world changes. What's important is that we recognize that we can put a foot in our mouth and offend people without knowing it. But, it's important to accept and digest feedback. The feedback can be bad or good but it should at least be considered, and hearing "yikes" is pretty mild all things considered.

That said, I really think you should reflect on how much research you did (read a wikipedia page) before stating that Africa's high HIV rates compared to the rest of the world are due to "a culture of rape/unprotected sex" or quack-medicine. (Also, I don't see "rape" anywhere on the wiki article you linked.)

> That said, I really think you should reflect on how much research you did (read a wikipedia page) before stating that Africa's high HIV rates compared to the rest of the world are due to "a culture of rape/unprotected sex" or quack-medicine.

I never stated those things authoritatively. I threw them out as potential example factors because those were things I saw during my brief wikipedia foray.

> (Also, I don't see "rape" anywhere on the wiki article you linked.)

Yeah because it wasn't on that page but a related page:

https://en.wikipedia.org/wiki/Virgin_cleansing_myth

> But to the point: the major driver of the early explosion of HIV on the continent was almost certainly large-scale vaccination and medical treatment campaigns by colonial governments, which injected staggering numbers of people in rural areas without adequate disinfection of needles.

Do you have a citation for that? I’ve never seen it authoritatively claimed and “almost certainly” seems strong for something which isn’t at the standards for inclusion on the Wikipedia page.

Unsterile needles are included on this wiki page https://en.wikipedia.org/wiki/History_of_HIV/AIDS#Emergence

Is there not an issue of “dry sex”, where men prefer unlubricated partners which without protection can contribute to a greater likelihood of transmission?

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