Sunday, 3 August 2008

USA's HIV figures all wrong

A new study, to be published in the Journal of the American Medical Association, suggests the USA's estimated rate of HIV infection has been far too low. According to the Centre for Disease Control:
New technology and methodology developed by CDC show that the incidence of
HIV in the United States is higher than was previously known. However, the incidence has been stable at that higher level for most of this decade. HIV incidence is the number of new HIV infections occurring during a certain time period, in this case, the year 2006.

These findings, published by in a special HIV/AIDS issue of the Journal of the American Medical Association (JAMA) that was released August 3, 2008, show
that in 2006, an estimated 56,300 new HIV infections occurred – a number that is
substantially higher than the previous estimate of 40,000 annual new infections. It should be noted that the new incidence estimate does not represent an actual increase in the numbers of HIV infections. Rather, a separate CDC historical
trend analysis published as part of this study suggests that the annual number of new infections was never as low as 40,000 and that it has been roughly stable since the late 1990s (with estimates ranging between 55,000 and 58,500 during the three most recent time periods analyzed).

The new estimates show that gay and bisexual men of all races and ethnicities and African American men and women are the groups most affected by HIV. Fifty three percent of all new infections in 2006 occurred in gay and bisexual men. African Americans, while comprising 13% of the US population, accounted for 45% of the new HIV infections in 2006. (1)
According to the details of the study,
In 2006, the rate of new infections among non-Hispanic blacks was 7 times the rate among whites (83.7 versus 11.5 new infections per 100,000 population). Blacks also accounted for the largest share of new infections (45%, or 24,900). Historical trend data show that the number of new infections among blacks peaked in the late 1980s and has exceeded the number of infections in whites since that time. (2)
This annoys me, because I see race as a useless category for definitions like this. What does 'black' mean? It is such a muddled way of categorising subjects as to be almost useless. All it tells us is that some people - with a slightly raised level of Melanin compared to the Caucasian 'norm,' are over represented. That's usless, as the category covers a huge range. Does it mean only people with 100% African heritage? 50%, like that nice Mr Obama or the ever delightful Ms Berry? 25%? 12.5%, which was the old definition of an 'Octroon,' and enough to get the unlucky bearer of enhanced Melanin sold as a slave? Or what?

The study's authors admit as much, pointing out:
Although race itself is not a risk factor for HIV infection, a range of issues contribute to the disproportionate HIV risk for blacks in the United States, including poverty, stigma, higher rates of other STDs, and drug use. (3)

Then why aren't the figues broken down by these factors instead? Why use a category which the study's authors admit is misleading?

The authors might argue that they are simply trying to highlight the over-representation of a social group in the statistics, but this is misleading. It isn't there place, as scientists, to attempt such sociological prestidigitation, but just to report the FACTS.

It is the usual American fixation on race, probably reflecting some weird hang up about 'black' sexuality, and also the desperate need to talk about anything other than social class. Heaven forbid if it were admitted that it was poverty, lack of education and lack of opportunity that defined your chances in life. Because these are all things that society can change, it it is minded to. Where as if it is down to race (can any one else see a "lazy negro" stereotype lutrking in the background here?") then there isn't much that nice, "white," mainstream society can do about it.

God's will, in other words.

1 - "HIV Incidence," unattributed article on the website of the Centre for Disease Control, 3rd of August, 2008. (http://www.cdc.gov/hiv/topics/surveillance/incidence.htm)
2 - "Estimates of New HIV Infections in the United States," by Hall HI, Song R, Rhodes P, Prejean J, An Q, Lee LM, Karon J, Brookmeyer R, Kaplan EH, McKenna MT, Janssen RS for the HIV Incidence Surveillance Group. Published in JAMA, 6th of AUgust, 2008. Reproduced on the Centre for Disease Control website. (
http://www.cdc.gov/hiv/topics/surveillance/resources/factsheets/incidence.htm)
3 - ibid.

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