There are at least three differences between the US and African
populations which tend to explain the gender disparities. The
third reason, below, may interest libertarians
Epidemiological studies have shown that circumcision reduces
transmission from women to men. In tribes which practice
male circumcision, the male to female ration is more like the US.
AIDS RESEARCH: Male Circumcision Thwarts HIV Infection
Science 5 August 2005: 860
View Free Summary
Also, transmission is facilitated by open wounds as Maden points out.
Untreated bacterial infections can lead to HIV infection.
Finally, there is a possibility that health care practices themselves have
spread the infection in developing countries. This theory is, of course,
unpopular and hard to document. But some facts suggest this, and
might interest libertarians.
Until the late 20th century, hypodermic needles where made of glass
and steel. They were sterilized with steam or boiling water.
Then, disposable syringes made of plastic displaced the durable kind.
They cannot be sterilized, but after one use they are thrown away.
This was intended to be safer, but in the real world, it was not.
To keep illegal drug users from obtaining needles, nurses are
instructed to break used needles and put them into special red boxes.
Of course, IV drug users still got the needles, only not very many of
them. They shared the needles, and used them over and over again.
Hepatitis and AIDS transmission became serious problems among
drug users in the US. Then, a few brave citizens started "needle
exchange" programs, illegally, in civil disobedience. Eventually,
such programs became legal or decriminalized.
But in poor countries, patients may not be treated by licensed doctors.
Even clinics may not have adequate funds for imported supplies. Do
plastic syringes ever get reused?
I think so, because it happens here! Last year a hospital in Nevada
exposed 40,000 patients to reused needles:
A few years ago, a clinic down the street from where I live found a
nurse had been reusing somewhat expensive "butterfly" syringes.
If needles get reused here, they probably get reused in Africa.
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