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Toward an Epidemiological Model of AIDS in Sub-Saharan Africa

Published online by Cambridge University Press:  04 January 2016

Extract

The outbreak of AIDS around the world in the last 15 or 20 years is usually referred to as the “AIDS epidemic,” or occasionally “pandemic” (Grmek 1990). These terms have no great analytic value. The major medical dictionaries and epidemiological textbooks define an epidemic merely as an outbreak of a disease marked by a greater number of cases than usual (see Fox et al. 1970: 246–49; Mausner and Bahn 1974: 22, 272–77; Stedman’s Medical Dictionary 1977: 470; Kelsey et al. 1986: 212; Walton et al. 1986: 351; Harvard 1987: 247). This condition is contrasted with the endemic form of a disease at “its habitual level, or what previous experience would lead one to anticipate.” The term pandemic is used to describe an epidemic widespread in the world and usually characterized by a large number of cases, for example, the fourteenth-century plague epidemic (or Black Death) and the influenza epidemic during the latter part of World War I. Some authorities stress the fact that epidemics are also characterized by a declining phase. This is true by definition, of course, for otherwise the disease could be described as shifting to a new and higher endemic level. But it is also of interest that most of these unusual outbreaks of disease are eventually limited by such mechanisms as a decrease in susceptibles as persons become immune or die; as interventions, either medical or behavioral, eliminate the source or interrupt transmission; or as the pathogen mutates and becomes less virulent.

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Special Section
Copyright
Copyright © Social Science History Association 1996 

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References

Anarfi, J. (1992) “Sexual networking in selected communities in Ghana and the sexual behaviour of Ghanaian female migrants in Abidjan, Côte d’Ivoire,” in Dyson, T. (ed.) Sexual Behaviour and Networking: Anthropological and Socio-Cultural Studies on the Transmission of HIV. Liège: Derouaux-Ordina: 4964.Google Scholar
Anarfi, J. (1993) “Sexuality, migration, and AIDS in Ghana,” in Caldwell, J. C., Santow, G., Orubuloye, I. O., Caldwell, P., and Anarfi, J. (eds.) Sexual Networking and HIV/AIDS in West Africa. Canberra: Australian National University: 4567.Google Scholar
Anarfi, J., and Awusabo-Asare, K. (1993) “Experimental research on sexual networking in some selected areas of Ghana,” in Caldwell, J. C., Santow, G., Orubuloye, I. O., Caldwell, P., and Anarfi, J. (eds.) Sexual Networking and HIV/AIDS in West Africa. Canberra; Australian National University: 2943.Google Scholar
Anderson, R. M. (1988) “The epidemiology of HIV infection: Variable incubation plus infectious periods and heterogeneity in sexual activity.Journal of the Royal Statistical Society 151: 6693.Google Scholar
Anderson, R. M., Baily, M. C., Garnett, G. P., and Rowley, J. T. (1991) “The spread of HIV-1 in Africa: Sexual contact patterns and the predicted demographic pattern of AIDS.Nature 352: 581-89.Google Scholar
Asin, J. (1952) “Chancroid: A report on 1,402 cases.American Journal of Syphilis, Gonorrhea, and Venereal Disease 36: 483-87.Google Scholar
Barley, N. (1988) A Plague of Caterpillars: A Return to the African Bush. Harmonds-worth: Penguin.Google Scholar
Berkley, S., Naamara, W., Okwara, S., Downing, R., Konde-Lule, J., Wawer, M., Mu-sagaara, M., and Musgrave, S. (1990) “AIDS and HIV infection in Uganda—Are more women infected than men?AIDS 4: 1237-42.Google Scholar
Bongaarts, J., Reining, P., Way, P., and Conant, F. (1989) “The relationship between male circumcision and HIV infection in African populations.AIDS 3: 373-77.Google Scholar
Caldwell, J. C., and Caldwell, P. (1983) “The demographic evidence for the incidence and cause of abnormally low fertility in tropical Africa.World Health Statistics Quarterly 36: 221.Google Scholar
Caldwell, J. C. (1993) “The nature and limits of the sub-Saharan African AIDS epidemic: Evi dence from geographic and other patterns.Population and Development Review 19: 817-48.Google Scholar
Caldwell, J. C. (1994) “The neglect of an epidemiological explanation for the distribution of HIV/AIDS in sub-Saharan Africa: Exploring the male circumcision hypothesis,” in Geland, J. and Way, P. (eds.) AIDS Impact and Prevention in the Developing World: Demographic and Social Science Perspectives. Canberra: Australian National University: 2346.Google Scholar
Caldwell, J. C., Caldwell, P., and Quiggin, P. (1989) “The social context of AIDS in sub-Saharan Africa.” Population and Development Review 15:185234.Google Scholar
Caldwell, J. C. (1991) “The African sexual system: Reply to Le Blanc et al.Population and Development Review 17: 506-15.Google Scholar
Caldwell, J. C., Orubuloye, I. O., and Caldwell, P. (1992) “Underreaction to AIDS in sub-Saharan Africa.Social Science and Medicine 34: 1169-82.Google Scholar
Caldwell, J. C., Santow, G., Orubuloye, I. O., Caldwell, P., and Anarfi, J., eds. (1993) Sexual Networking and HIV/AIDS in West Africa. Canberra: Australian National University.Google Scholar
Cameron, D. W., Simonson, J. N., D’Costa, L. J., Ronald, A. R., Maitha, G. M., Gakinya, M. N., Cheang, M., Ndinya-Achola, J. O., Piot, P., Brenham, R. C., and Plummer, F. A.. (1989) “Female to male transmission of human immunodeficiency virus type 1: Risk factors for seroconversion in men.” Lancet, 19 August: 403-7.Google Scholar
Carael, M., van de Perre, P. H., Lepage, P. H., Allen, S., Nsengumuremyi, F., Van Goethem, C., Ntahorutaba, M., Nzaramba, D., and Clumeck, N. (1988) “Human immunodeficiency virus transmission among heterosexual couples in central Africa.AIDS 2: 201-5.Google Scholar
Davenport-Hines, R. (1990) Sex, Death, and Punishment: Attitudes to Sex and Sexuality in Britain since the Renaissance. London: Collins.Google Scholar
de Vincenzi, I., and Mertens, T. (1994) “Male circumcision: A role in HIV prevention?AIDS 8:153-60.Google Scholar
Dyson, T., ed. (1992) Sexual Behaviour and Networking: Anthropological and Socio-Cultural Studies on the Transmission of HIV. Liège: Derouaux-Ordina.Google Scholar
Fortes, M. (1978) “Family, marriage, and fertility in West Africa,” in Oppong, C., Adaba, G., Bekombo-Priso, M., and Mogey, J. (eds.) Marriage, Fertility, and Parenthood in West Africa. 2 vols. Changing African Family Project Monograph Series, No. 4. Canberra: Australian National University, Department of Demography 1: 1754.Google Scholar
Fox, J. P., Hall, C. E., and Elveback, L. R. (1970) Epidemiology: Man and Disease. New York: Macmillan.Google Scholar
Greenberg, H. (1972) “Venereal disease in the armed forces.Medical Clinics of North America 56: 10871100.Google Scholar
Grmek, M. D. (1990) History of AIDS: Emergence and Origin of a Modern Pandemic. Trans. Maulitz, R. C. and Duffin, J.. Princeton, NJ: Princeton University Press.Google Scholar
Hart, G. (1975) “Venereal disease in a war environment: Incidence and management.Medical Journal of Australia 1: 808-10.Google Scholar
Harvard, C. W. H., ed. (1987) Black’s Medical Dictionary. 35th ed. Totowa, NJ: Barnes and Noble.Google Scholar
Health Studies Branch, Center for International Research, U.S. Bureau of the Census (1993) “Recent HIV seroprevalence levels by country: December 1993.” Research Note No. 11. Washington, DC: U.S. Bureau of the Census.Google Scholar
Hill, A. B. (1965) “The environment and disease: Association or causation?Proceedings of the Royal Society of Medicine 58: 295300.Google Scholar
Hudson, C. P., Hennis, A. J. M., Kataaha, P., Lloyd, G., Moore, A. T., Sutehall, G. M., Whetstone, R., Wregghit, T., and Karpas, A.. (1988) “Risk factors for the spread of AIDS in rural Africa: Evidence from a comparative seroepidemiological survey of AIDS, hepatitis B, and syphilis in southwestern Uganda.AIDS 2: 255-60.Google Scholar
Kelsey, J. L., Thompson, W. D., and Evans, A. S. (1986) Methods in Observational Epidemiology. Monographs in Epidemiology and Biostatistics, No. 10. New York: Oxford University Press.Google Scholar
Konde-Lule, J. K. (1996) “The declining HIV seroprevalence in Uganda: What evidence?” in Caldwell, J. C., Orubuloye, I. O., Caldwell, P., and Jain, S. K. (eds.) The Third World AIDS Epidemic. Canberra: Australian National University.Google Scholar
Konings, E., Blattner, W. A., Levin, A., Brubaker, G., Siso, Z., Shao, J., Goedert, J. J., and Anderson, R. M. (1994) “Sexual behaviour survey in a rural area of northwest Tanzania.AIDS 8: 987-93.Google Scholar
Mann, J., Tarantola, D. J. M., and Netter, T. W., eds. (1992) AIDS in the World. Cambridge, MA: Harvard University Press.Google Scholar
Mausner, J. S., and Bahn, A. K. (1974) Epidemiology: An Introductory Text. Philadelphia: Saunders.Google Scholar
Mercer, A. (1990) Disease Mortality and Population Transition. Leicester: Leicester University Press.Google Scholar
Moses, S., Bradley, E., Nagelkerke, N. J. D., Ronald, A. R., Ndinya-Achola, J. O., and Plummer, F. A. (1990) “Geographical patterns of male circumcision practices in Africa: Association with HIV seroprevalence.International Journal of Epidemiology 19: 693-97.Google Scholar
Moses, S., Plummer, F. A., Ngugi, E. N., Nagelkerke, N. J. D., Anzala, A. O., and Ndinya-Achola, J. O. (1991) “Controlling HIV in Africa: Effectiveness and cost of an intervention in a high-frequency STD transmitter core group.AIDS 5: 407-11.Google Scholar
Mulder, D. W., Kengeya-Kayondo, J. F., Sempala, S. D. K., and Nunn, A. J. (1993) MRC/ODA/UVRI Programme Annual Report, 1992. Medical Research Council (U.K.), Overseas Development Administration (U.K.), and Uganda Virus Research Institute, Entebbe.Google Scholar
Muller, J.-C. (1969) “Preferential marriage among the Rukuba of Benue-Plateau State, Nigeria.American Anthropologist 71: 1057-61.Google Scholar
Murdock, G. P. (1967a) Ethnographic Atlas. Pittsburgh: University of Pittsburgh Press.Google Scholar
Murdock, G. P. (1967b) “Ethnographic Atlas: A summary.Ethnology 6: 109236.Google Scholar
Murray, C., and Chen, L. C. (1993) “In search of a contemporary theory for understanding mortality change.Social Science and Medicine 36: 143-55.Google Scholar
Ogbuagu, S. C., and Charles, J. O. (1993) “Survey of sexual networking in Calabar,” in Caldwell, J. C., Santow, G., Orubuloye, I. O., Caldwell, P., and Anarfi, J. (eds.) Sexual Networking and HIV/AIDS in West Africa. Canberra: Australian National University: 105-19.Google Scholar
Oloko, B. A., and Omoboloye, A. O. (1993) “Sexual networking among some Lagos adolescent Yoruba students,” in Caldwell, J. C., Santow, G., Orubuloye, I. O., Caldwell, P., and Anarfi, J. (eds.) Sexual Networking and HIV/AIDS in West Africa. Canberra: Australian National University: 151-57.Google Scholar
Omorodion, F. (1993) “Sexual networking among market women in Benin City, Bendel State, Nigeria,” in Caldwell, J. C., Santow, G., Orubuloye, I. O., Caldwell, P., and Anarfi, J. (eds.) Sexual Networking and HIV/AIDS in West Africa. Canberra: Australian National University: 159-69.Google Scholar
Oriel, J. D. (1982) “The global pattern of sexually transmitted diseases.South African Medical Journal 26: 995.Google Scholar
Orubuloye, I. O., Caldwell, J. C., and Caldwell, P. (1991) “Sexual networking in the Ekiti District of Nigeria.Studies in Family Planning 22: 6173.Google Scholar
Orubuloye, I. O. (1992) “Diffusion and focus in sexual networking: Identifying partners and partners’ partners.Studies in Family Planning 23: 343-51.Google Scholar
Orubuloye, I. O. (1994a) “The role of religious leaders in changing sexual behaviour in southwest Nigeria in an era of AIDS,” in Orubuloye, I. O., Caldwell, J. C., Caldwell, P., and Santow, G. (eds.) Sexual Networking and AIDS in Sub-Saharan Africa: Behavioural Research and the Social Context. Canberra: Australian National University: 117-27.Google Scholar
Orubuloye, I. O. (1994b) “The cultural, social, and attitudinal context of male sexual behaviour.” Report to SAREC Project Workshop, Ado-Ekiti, August.Google Scholar
Orubuloye, I. O., Caldwell, J. C., Caldwell, P., and Santow, G., eds. (1994c) Sexual Networking and AIDS in Sub-Saharan Africa: Behavioural Research and the Social Context. Canberra: Australian National University.Google Scholar
Orubuloye, I. O., Caldwell, P., and Caldwell, J. C. (1994d) “Commercial sex workers in the shadow of AIDS,” in Orubuloye, I. O., Caldwell, J. C., Caldwell, P., and Santow, G. (eds.) Sexual Networking and AIDS in Sub-Saharan Africa: Behavioural Research and the Social Context. Canberra: Australian National University: 101-16.Google Scholar
Oyeneye, O. Y., and Kawonise, S. (1993) “Sexual networking in Ijebu-Ode, Nigeria: An exploratory study,” in Caldwell, J. C., Santow, G., Orubuloye, I. O., Caldwell, P., and Anarfi, J. (eds.) Sexual Networking and HIV/AIDS in West Africa. Canberra: Australian National University: 171-83.Google Scholar
Piot, P., and Laga, M. (1989) “Genital ulcers, other sexually transmitted diseases, and the sexual transmission of HIV: The first two may be important risk factors for the third.British Medical Journal 298: 624.Google Scholar
Plummer, F. A., Moses, S., and Ndinya-Achola, J. O. (1991) “Factors affecting female to male transmission of HIV-1: Implications of transmission dynamics for prevention,” in Chen, L. C., Sepúlveda, J., and Segal, S. J. (eds.) AIDS and Women’s Reproductive Health. Language of Science. New York: Plenum: 3545.Google Scholar
Quétel, C. (1990) History of Syphilis. Trans. Braddock, J. and Pike, B.. Cambridge: Polity.Google Scholar
Romaniuk, A. (1968) “Infertility in tropical Africa,” in Caldwell, J. C. and Okonjo, C. (eds.) The Population of Tropical Africa. London: Longmans: 214-24.Google Scholar
Shorter, E. (1992) “What can two historical examples of sexually-transmitted disease teach us about AIDS?” in Dyson, T. (ed.) Sexual Behaviour and Networking: Anthropological and Socio-Cultural Studies on the Transmission of HIV. Liège: Derouaux-Ordina: 4964.Google Scholar
Stedman’s Medical Dictionary (1977) 23d ed. Baltimore: Williams and Wilkins.Google Scholar
van de Perre, P., Carael, M., Nzaramba, D., Zissis, G., Kayihigi, J., and Butzler, J. P. (1987) “Risk factors for HIV seropositivity in selected urban-based Rwandese adults.AIDS 1: 207-11.Google Scholar
Walton, J., Beeson, P. B., and Scott, R. B., eds. (1986) The Oxford Companion to Medicine. 2 vols. Oxford: Oxford University Press.Google Scholar
Ward, E. (1937) Marriage among the Yoruba. Washington, DC: Catholic University of America.Google Scholar
Ward, E. (1938) The Yoruba Husband-Wife Code. Washington, DC: Catholic University of America.Google Scholar
Way, P. O., and Stanecki, K. A. (1993) An Epidemiological Review of HIV/AIDS in Sub-Saharan Africa. Washington, DC: Center for International Research, U.S. Bureau of the Census.Google Scholar
World Bank (1994) World Development Report, 1994. New York: Oxford University Press.Google Scholar