DECONSTRUCTING HIV/AIDS in “SUB-SAHARAN AFRICA” and “THE CARIBBEAN”

Sub-Saharan Africa is being ravaged by HIV/AIDS, so we are incessantly reminded by the media, UNAIDS, the World Health Organization, the World Bank, innumerable charities named for or supported by prominent celebrities, and innumerable activists and activist groups. Disseminating global and regional numbers, UNAIDS invariably refers to “sub-Saharan Africa” as though it were an entity analogous to Asia, Eastern Europe and Central Asia, Latin America, North America, Western Europe, Oceania, or Middle East and North Africa.

But those incessant expressions of grave concern may be the only thing that unites “sub-Saharan Africa”, because little if anything is really common to every one of those 40-odd countries, HIV/AIDS perhaps least of all. In sub-Saharan Africa, as also in the Caribbean, the reported “HIV prevalence” varies widely— indeed wildly—from country to country; whereas in the rest of the world, HIV prevalence is rather uniformly distributed within and between the regions of Asia, Eastern Europe and Central Asia, Latin America, North America, Western Europe, Oceania, Middle East and North Africa—where, at significantly less than 1%, “HIV” is also much less than in “sub-Saharan Africa” and “the Caribbean”.

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Caribbean

The UNAIDS report for 2006 gives the “HIV-positive” rate for the Caribbean as 1.6% (± 0.6), but for individual islands what’s reported is between 0.1% and 3.8%. There is no obvious reason why the average of such widely varying numbers should mean anything. Looking at the countries separately, there appears once again something like a correlation with race, in particular African ancestry:

Note particularly the differences between Haiti and the Dominican Republic, which share a land border but differ drastically in levels of “HIV” and in their proportions of people of African ancestry.

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Sub-Saharan Africa

“Sub-Saharan Africa” displays a similar non-uniformity of “HIV”-positive rates, ranging from highs of 38.8% and 37.3% in the south [sic–these extraordinary numbers are not typos] to 1% or less in Senegal in the West and Somalia in the East:

These variations in “HIV” are more clearly discernible if country names are omitted:

and the trends may be seen even more readily if numbers are replaced by varied intensity of shading (≤ 1%; 1-3%; 3-6%; 6-9%; 9-13%; 13-20%; 20-25%; ≥ 25%; no data were found for Western Sahara; the 3 white blots in the mid-eastern section are bodies of water):

This does not look much like the distribution of something infectious or contagious, something supposed to spread primarily via sexual intercourse; particularly not when the purported agent of infection is said to have affected human beings for the first time in West Central Africa http://mbe.oxfordjournals.org/cgi/content/short/24/8/1853 or Cameroon (Keele et al., Science, 313 [2006] 523-6) early in the 20th century, jumping in some manner from chimpanzees; the highest frequencies of positive tests–by far–are in the extreme south, not around Cameroon.

Whereas this distribution does not look like the spread of an infection, it does look rather plausible as the distribution of human genetic haplotypes. Certainly it bears a resemblance to the distribution of language families in Africa:

There has been considerable controversy over the purported connection between language and human genetics, but there may well be a correlation over time-spans on the order of centuries or a millennium or two. In this instance, there is a plausible similarity with the great Bantu migration that began a millennium or two ago:

Overall, there seems to be a correlation between the distribution of “HIV” in Africa and the genetic connections suggested by Cavalli-Sforza (Genes, People, and Languages, North Point Press [Farrar, Straus & Giroux], 2000):

Note particularly the distance between Bantu and West African, and even more between those and Ethiopian, and especially San, the “Bushmen of the Kalahari”, who have a low rate of “HIV-positive” yet dwell in the region of (Bantu-populated) Botswana and Swaziland where “HIV” ≥ 35%.

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In the United States, the geographic distribution of “HIV-positive”—which has remained constant since testing began—can be calculated with good accuracy from the regional variations in racial composition of the population (see p. 66 ff. in The Origin, Persistence and Failings of HIV/AIDS Theory). With only 4 levels of shading in each of the following two maps, by chance just 12 states (48/4) would have the same color in both maps; but here, 31 states are shaded the same in both figures, much better than chance. This is consistent with the conclusion that the racial composition of the population is the chief determinant of rates of testing “HIV”-positive.

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The geographic correlations described in this post are perhaps suggestive more than probative. However, there is obviously no justification for talking about HIV/AIDS in “sub-Saharan Africa” as though something were common about it throughout that region. “AIDS in sub-Saharan Africa” is a sound-bite useful for propaganda; but like so many sound-bites, it is drastically misleading.

It is not just suggestive, however, but quite solid fact, acknowledged in innumerable official reports and mainstream publications, that “HIV” in the United States affects people in the officially used racial and ethnic groups quite differently, and persistently in the sequence

Asian < white < Native American < Hispanic < black

There is evidently some sort of genetic basis for the tendency to test “HIV”-positive. Or one might put it like this:

“HIV” tests are racially biased.