Important note: Information in this article was accurate in 1995. The state of the art may have changed since the publication date.
The Associated Press - 21 Sep 1995
The issue raised in the current edition of The Lancet has long been a touchy one.
"Many of us have preferred to remain silent on this issue out of fear of having our analyses denatured into arguments for mass testing and deportation," wrote Dr. Josef Decosas, co-author of the article and director of the Regional AIDS Program in Accra, Ghana.
"But silence has ceased to be an option. Population migration has become a central theme in the discussion of AIDS, and we have an obligation to engage in this discussion in order to prevent it from producing grist for the mills of xenophobia."
The scientists blame the higher rate of AIDS among migrant workers on prostitutes patronized by workers separated from their families. Those who stay at home, they say, are less likely to engage in extramarital sex that raises the risk of infection.
Although the article was published as an opinion piece rather than a scientific study, the researchers cited statistics from studies.
For example, they said a study of more than 5,000 Ugandans showed the rate of HIV infection -- the precursor of AIDS -- was 5.5 percent among people who never moved compared with 12.4 percent among those who moved to a different village. Similar findings emerged in a study in Senegal, they said.
The notion of pointing out the situation among migrants has been politically sensitive because AIDS workers fear governments may resort to discriminatory policies, such as deportation.
The authors instead advocate educating the migrants to practice safe sex and not to frequent prostitutes.
Dr. Robert Shope, an infectious disease expert and professor of pathology at University of Texas Medical Branch, said the suggestion was a good one but probably wouldn't work.
"I think what they are trying to do is worthy, it's really great, but it's a social aim that probably isn't going to succeed," he said.
Shope added that molecular studies, which track a particular strain of HIV virus, are necessary to show conclusively that migrant workers are spreading the disease.
The other authors of the essay were Dr. F. Kane of the Center of International Cooperation, Health and Development, in Abidjan, Ivory Coast; J.K. Anarfi of the University of Ghana; K.D.R. Sodji, of the Action Force for the Improved Well-Being of Mother and Child, in Togo; and Dr. H.U. Wagner, of the Division of Health, Population and Nutrition, in Eschborn, Germany.
Copyright 1995/The Associated Press. Reproduced with permission. Reproduction of this article (other than one copy for personal reference) must be cleared through the Permissions Desk, The Associated Press, 50 Rockefeller Plaza, New York, NY 10020.
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