Prisoners, chimpanzees and HIV infection

This post is devoted to HIV transmission. The opportunity is given by two occurrences, a research paper published on the July 14 issue of The Lancet  "HIV, prisoners, and human rights" and a press release issued on July 22 by the University of Nebraska-Lincoln concerning a study on cross-species HIV infection. The Lancet paper discusses the spread of infectious diseases, and notably HIV infection, in prisons. Researchers focus on (dis)humane prison conditions and human right abuse. HIV infection is as inherent to the criminal justice system as researchers come to state that HIV infection is almost an atrocious additional punishment. Moreover, the spread of disease within prisons is not a self-limiting phenomenon, without any consequence for the whole society. On the contrary, one of the major consequences of HIV infection in prison is the spread of HIV into the community, when inmates are released, which contributes substantially to keep HIV infection endemics in some regions. The Nebraska Center for Virology press release regards a study just published by the Journal of Virology that confirms the hypothesis of a zoonotic origin of HIV infection. Researchers have identified two strains of chimpanzee-carried SIVs that can still infect human cells. These strains include the SIV ancestor of HIV-1 M – the strain responsible for the global HIV pandemic – and another ancestral strain of HIV found only among residents of Cameroon. The study aims to go beyond a research on the natural history of HIV infection,  nice but with few practical effects, because researchers claim that it "provides evidence that SIVcpz viruses (...)  still have the potential to cause a future HIV-1 like zoonotic outbreak". In other words, they argue that, as SIV crossed species in the past, it is still possible that this can happen today, posing new unpredictable threats to human health, causing new epidemics, even, they say, "a pandemic".

These two news share various elements, they both concern HIV infection and its transmission. Moreover, they are both a warning about the future, inviting not to relax too much and continuing taking HIV seriously. Finally, they are both a challenge to health communication. In the first case, it is very difficult to communicate the message that researchers aim to communicate, say, the need to distribute routinely condoms in prisons. It is easy that their study gets the opposite effect, say, causes a request to increase measures of control and surveillance. There is an everlasting denial of homosexual relations in prisons, which is particularly bizarre today, when in most countries the gay marriage is standardly accepted. Researchers implicitly, and - I suppose - unwittingly, equal homosexual relations in prison to cruel and inhuman conditions and this would be funny, if it were not outrageous.

The second study is apparently more innocuous. Luckily, today not even fascists dare any longer idiot and racist jokes on simian origins of HIV infection. Yet, researchers should be more aware that life conditions in Africa have radically changed since early 1900, when it is likely that SIV first crossed species barriers. How many butchers sell today chimpanzee's steaks?  How many people still go hunting chimpanzees? How many people live in areas where it could happen to be bitten by a chimpanzee? Brief, one cannot exclude the theoretical risk of a new HIV-1 like zoonotic outbreak, but I do doubt that it makes sense to warn seriously about such a risk.  This is clearly a way they use to emphasize the importance of their discovery, but a medical study can be significant also if it does not unravel new risks. This is a lesson not only for them but for everybody.