The promiscuous spread of Aids in Africa:

The Sunday Times:

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HIV is largely a sexually transmitted infection, so there must be something different about sex in Africa. Yet you can’t say that without appearing to be racist. So campaigners have come up with other reasons that HIV is worse in Africa: poverty, ignorance, men having more power than women. All politically correct, but not epidemiologically correct.

The truth is that a society in which many people have two or three partners on the go at any one time will produce a bigger epidemic than a society where people may have 10 partners in five years, but only one at a time. And it’s a fact that in parts of Africa, it’s more common for both men and women to have two or three simultaneous relationships than to have serial partners. Do people behave in this way because they are poor and ignorant? Not in Bangladesh, or Bolivia, or dozens of other countries where incomes and literacy are low. Indeed, in Africa, the incidence of HIV infection is highest in the richest households and the richest countries.

In east Africa, HIV spread first among people who had lots of partners – in other words, men and women who traded sex for money or favours. Had condom use in commercial sex been pushed to very high levels at the time – as happened in Thailand – the epidemic would have been contained.

But most African leaders played Three Monkeys. So a miner infected a prostitute, who infected another client, who went home and infected his wife, who infected her regular boyfriend. Suddenly, HIV was everyone’s problem.

In Africa. Outside the continent, most people infected with HIV are men who have anal sex with other men, people who inject drugs and people who buy and sell sex, as well as their lovers. Indeed, it was these groups that first surfed into public consciousness....

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In east and southern Africa, two decades of denial and mismanagement have allowed the HIV virus to hollow out whole countries. In the rest of the world, HIV continues to threaten men and women who inject drugs, buy sex or sell it, as well as men who have sex with one another. The lovers of those people are at risk, too.

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The Bush administration has actually done a good job of fighting Aids in Africa. In some countries the progress has been remarkable. In countries like Zimbabwe where the leadership is abysmal, there has been little success. Without addressing the problem of promiscuity, the problem will continue to spread.