In 2010, young gay and bisexual men (aged 13-24 years) accounted for **72%** of new HIV infections among all persons aged 13 to 24
CDC – Fact Sheet - Gay and Bisexual Men – Gender – Risk – HIV/AIDS
This is staggering. This obviously implies that anal sex is the primary means of HIV transmission. Of course needles make it a compounding problem but its not the source. If we had less people being exposed to HIV there would be a dramatic decrease in transmissions via needles. Not the other way around.
Your comments on Africa are outdated and inaccurate.
Perhaps the most important anthropological report of homosexual behaviour in Africa is Lockhart’s
14, who studied street boys in Mwanza, Tanzania (a city with a 11.8% adult HIV prevalence). Such a study should raise researchers’ index of suspicion for seeking self-reports of, especially, receptive anal intercourse, irrespective of sex. The boys in Mwanza, aged eight to 20, report having anal intercourse with other street boys, as part of initiation rites (i.e., forced receptive anal intercourse, by a gang of boys) into street boy culture and, following acceptance into the street life, occasionally awakening from sleep to find themselves being anally penetrated. Prostitution was rare; anal intercourse was placed in context of belonging to the group, as well as an exercise of power. Anal intercourse with older men known or not known to the street boys was also reported and often attributed to prison rape. By age 18, all boys also reported heterosexual sex; unfortunately, no information regarding heterosexual anal intercourse is provided. None of the boys considered their same-sex intercourse to be a homosexual act
14.
For more on this see:
Assessing the role of anal intercourse in the epidemiology of AIDS in Africa
Your study says:
"Our inquiry into the available, admittedly sparse, published literature suggests that anal intercourse is much more common in the populations living in sub-Saharan Africa than customarily suspected or reported by clinicians and researchers."
Entirely possible.
Also, something else.
Sub-Saharan Africa remains the hardest-hit region. HIV infection is becoming
endemic in sub-Saharan Africa, which is home to just over 12% of the world’s population but two-thirds of all people infected with HIV.
[12] The adult HIV prevalence rate is 5.0% and between 21.6 million and 24.1 million total are affected.
[12] However, the actual prevalence varies between regions. Presently,
Southern Africa is the hardest hit region, with adult prevalence rates exceeding 20% in most countries in the region, and 30% in
Swaziland and
Botswana.
Eastern Africa also experiences relatively high levels of prevalence with estimates above 10% in some countries, although there are signs that the pandemic is declining in this region.
West Africa on the other hand has been much less affected by the pandemic. Several countries reportedly have prevalence rates around 2 to 3%, and no country has rates above 10%. In Nigeria and Côte d'Ivoire, two of the region's most populous countries, between 5 and 7% of adults are reported to carry the virus.
Across Sub-Saharan Africa, more women are infected with HIV than men, with 13 women infected for every 10 infected men. This gender gap continues to grow. Throughout the region, women are being infected with HIV at earlier ages than men. The differences in infection levels between women and men are most pronounced among young people (aged 15–24 years). In this age group, there are 36 women infected with HIV for every 10 men. The widespread prevalence of
sexually transmitted diseases, the practice of
scarification,
unsafe blood transfusions, and the poor state of
hygiene and
nutrition in some areas may all be facilitating factors in the transmission of HIV-1 (Bentwich et al., 1995).
Mother-to-child transmission is another contributing factor in the transmission of HIV-1 in developing nations. Due to a lack of testing, a shortage in antenatal therapies and through the feeding of contaminated breast milk, 590,000 infants born in developing countries are infected with HIV-1 per year.
In 2000, the World Health Organization estimated that 25% of the units of blood transfused in Africa were not tested for HIV, and that 10% of HIV infections in Africa were transmitted via blood.
Poor economic conditions (leading to the use of dirty needles in healthcare clinics) and lack of
sex education contribute to high rates of infection. In some African countries, 25% or more of the working adult population is HIV-positive.
Poor economic conditions caused by slow onset-emergencies, such as drought, or rapid onset natural disasters and conflict can result in young women and girls being forced into using sex as a survival strategy.[15] Worse still, research indicates that as emergencies, such as drought, take their toll and the number of potential 'clients' decreases, women are forced by clients to accept greater risks, such as not using contraceptives.[15]
Epidemiology of HIV/AIDS - Wikipedia, the free encyclopedia
Again though, even if my statement was wrong, and anal sex was the number one way AIDs spread through Africa, that still wouldn't qualify your original statement, "Only those predisposed at birth would still be potential carriers," which would be patently wrong regardless.
