Race, Sex, and the Neglected Risks for Women and Girls in Sub-Saharan Africa

Abstract

Global AIDS policy has failed to stop the spread of HIV in sub-Saharan Africa because prevention programs are limited by an unscientific theory of disease causation, which assumes that differences in HIV prevalence among populations are adequately explained by variation in rates of unsafe sexual behaviors. But differences in sexual behavior cannot explain 250-fold differences in HIV prevalence among countries and increasing divergence in incidence. Such disparities point to biological characteristics of the pathogen, the host, and the environment, all of which influence individual risk of infection and the spread of infectious diseases in populations. This paper explores the ways in which Western constructions of race and sexuality have drawn attention to sexual behavior alone and away from scientific evidence of biological risk factors that increase HIV transmission in poor populations. Much of the discussion addresses sub-Saharan Africa, but the biological implications could apply to poor people in other regions.

Keywords:

• Gender
• HIV/AIDS
• race
• JEL Codes: I12, I1, I

Notes

I use the term racial science, instead of pseudo-science, which would seem preferable, because “racial science” was considered mainstream science in the nineteenth and early twentieth centuries.

Eugenicists also used physical measurements, such as craniometry, in an attempt to demonstrate the genetic superiority of men over women.

John Caldwell joined the Society for the Study of Social Biology in 1974, the year after it had changed its name from the American Eugenics Society (Eugenics Watch).

See N. E. MacDonald, G. A. Wells, W. A. Fisher, W. K. Warren, M. A. King, J. A. Doherty, and W. R. Bowie 1990; Tom W. Smith 1991; Kathryn Kost and Jacqueline E. Darroch Forrest 1992; June M. Reinisch, Stephanie A. Sanders, Craig A. Hill, and Mary Ziemba-Davis 1992; John O.G. Billy, Koray Tanfer, William R. Grady, and Daniel H. Klepinger 1993; Olga Grinstead, Bonnie Faigeles, Diane Binson, and Rani Eversley 1993; Russell Turner 1993; Susheela Singh and Jacqueline E. Darroch 1999.

Viral load is the concentration of HIV RNA in the blood, semen, and vaginal fluids, and it is the best predictor of HIV transmission between infected persons and their uninfected partners (Thomas Quinn, Maria Wawer, Nelson Sewankambo, David Serwadda, Xianbin Li, Fred Wabwire-Mangen, Mary Meehan, Thomas Lutalo, and Ronald Gray 2000).

Tommy Hlaing 1993; Richard Oberhelman, Efraim Guerrero, Marta Fernandez, Margarita Silio, Doris Mercado, Nora Comiskey, Gertrude Ihenacho, and Robertino Mera 1998; Partnership for Parasite Control (PPC) 2002; World Health Organization (WHO) 2005.

Urinary schistosomiasis caused by Schistosoma hematobium is found almost exclusively in sub-Saharan Africa and is highly endemic in much of the region (World Health Organization [WHO]2004b).