The evidence strongly suggests that HIV is not spread by insect bites but in one case it seems to have been caught from a human bite.

Lesbians are not a high-risk group (although 80 per cent have had heterosexual intercourse). However, one case of female-to-female spread might have arisen. For example, lesbian activities in the presence of menstruation might increase the risk of transmission but what actual sex took place is not known in this particular case. Woman-to-man spread has certainly occurred and in one instance after only two sexual episodes.

Lavatory seats are an unlikely source of infection with HIV but theoretically the water in the toilet could contain HIV if the previous user was infected. Water splashes have transmitted trichomonas to the vulva. Since most women crouch over rather than sit on a strange toilet there is not much risk but as a precaution the toilet could be flushed before use. Acupuncture could transmit infection but there should be no risk if a professionally qualified acupuncturist is used. Tattooing, at least theoretically, could be risky, as could activities involving body piercing.

Why HIV disease and AIDS are largely heterosexual diseases in Central and East Africa, especially in the towns, but not in the West is not known but suggestions have been made that the practice of circumcising girls may be important since they can then perhaps be infected more easily. Many of the prostitutes in these areas are infected and patronage of prostitutes is high. The fact that women are as likely, and in some cases more likely, to carry HIV than men is a major source of worry to those concerned with prevention in these areas. The question is could it happen here? The evidence seems to say that it could. The more people who are infected in the world the more likely is the virus to spread here, so helping other countries to control AIDS is a way of helping ourselves.

Although it is repeatedly said that no health worker has caught HIV from a patient this is not true. Health workers are at some small risk. However, some doctors, dentists and nurses have become neurotic about it and may even refuse to treat a patient they know or suspect is HIV-positive. This is understandable but reprehensible. Recently prisoners working in a prison laundry refused to wash the underclothes of an HIV-positive prisoner although there is no risk. The Governor, to make a point, washed them himself by hand. This sort of episode points to the fact that many people form an unreasonable fear of AIDS which is sometimes referred to as FRAIDS.

Because many male prisoners become involved with homosexuality in prison the World Health Organisation has recommended that they be supplied with condoms. In the UK there are about 70 prisoners known to be HIV-positive. Both the UK and the US

Governments have refused to go along with the WHO suggestion for fear of it increasing homosexual behaviour. Since many men in prison behave homosexually from need (or ‘persuasion’ by other prisoners) and not choice, they revert to heterosexuality on release and so may help to spread HIV.

If possible drug injectors should cease or change their habits but if they cannot needles should not be shared. In respect of blood transfusions the safest blood to receive is your own. Some centres now offer a service whereby one’s own blood is removed and stored before an operation which might require blood is carried out.


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