Spreading HIV

IIRC, there are a number of factors in play there. First, fewer men there tend to be circumcised, and being circumcised reduces a man's likelihood of being infected with HIV. Second, there is a greater prevalence of people who have other STDs, and having an STD increases the likelihood of an HIV infection. Finally, poverty and violence there leads to people being less healthy, in general. A compromised immune system is more likely to succumb to an HIV exposure.

HIV is, relatively speaking, inefficient; you are much less likely to be infected by it than you are by, say, gonorrhea or syphilis. Lots of people get exposed to it without being infected by it. But factors such as those I mention make it more likely that a given exposure is going to result in an infection.

 

We're a generation into this disease. The mother-to-child transmission means that that women in Africa are much more at risk, because so many men have the virus, as opposed to North America, where the vast majority of men with the virus either have sex with other men, or are IV drug users.

Testing is much less prevalent. So, while the story that kicked of this thread is rare here, and most infected people are aware of their status and seek to prevent its spread, that doesn't happen there.

HIV positive males may not know their status, and spread it unknowingly. And, since condom use is rare, it's going to spread more easily.

Then, look at the other factors your quote brings up -- sex workers, truck drivers, and migrant workers. Lots to contrast between Africa & North America in this regard as well. Just as an example, condoms are the norm among sex workers in North America -- much to Eliot Spitzer's chagrin.

We'd be remiss in leaving out the differences in attitudes regarding homosexuality and bi-sexuality between Africa and North America. While (segments) of North America may not embrace all lifestyles, it is extremely taboo in portions of Africa. It could get you killed. So, there are lots of men who have sex with other men, who also have sex with their wives. I would imagine truck drivers and migrant workers would be at the top of this list.

And, even in North America, it is this behavior that puts women at risk. It's a part of why the rate of infection is higher among African-American women, and it's also an issue among some deeply religious men.

Add in rape as a spoil of war, and you have a perfect storm for transmission.

So, if I travel to sub-Saharan Africa, I will be much more careful about choosing my sex partners.

As it is, I still don't think I have much to worry about.

 

I had one done probably four months ago.

Got a bill in the mail the other day, my insurance won't cover it.