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Friday, 6 June 2008

The "Sugar Daddy" Effect?

An interesting graph from CSO May Edition highlights the problem that has puzzled HIV experts for a while. Basically, in contries with high infection rates, female HIV prevalence always tends to peak around age 30, whereas it peaks some 10 - 15 years later for males. This pattern remains largely unexplained, and many believe that explanation of women having older sexual partners does not fully the phenomenon. Among the alternative explanations includes the idea that younger women may simply be more susceptible to HIV infection than younger men due to Herpes simplex virus type 2 infection, which is more prevalent in young women than in young men.


  1. Basically, in contries with high infection rates, female HIV prevalence always tends to peak around age 30, whereas it peaks some 10 - 15 years later for males.

    Maybe the explanatory factor is pregnancy. The more mature women become, the more likely they become to be or have been pregnant.

    Pregnancy is one reason for false positive ELISA tests. From The Body:

    Afriad of my questions?
    Aug 19, 2006


    I have a long story but will make it short and to the point.

    I have had two False positive ELSA test results (1st pregnant 2nd a reccent vaccination) I have had 4 NEGATIVE Western blot results (I have had the same parnter since 2002 and he is negative. My aunt has also had a Fasle postive HIV ELSA test.

    My questions are 1. Is there something wrong with the women in my family, that we have these results. 2. Will my daughter be the same way (is this heredity) 3.I'm scared to have another child becasue i don't want to live through this again. Will this happen again 4. Why me! Why does this happen.

    I know I am blessed and lucky to be negative but why is everyone is afraid to answer why and afriad to inform ppl that false-positive results happen.

    Thanks so much

    Response from Dr. Frascino


    No, we are certainly not afraid of your questions. In fact, they've been addressed multiple times in the archives. Have a look! I'll also reprint a recent archival post below.

    To briefly specifically address your questions:

    1. No, there is nothing wrong with you or the women in your family. It's primarily a limitation of the testing assay that picks up cross-reacting proteins that can occur in women who are or who have been pregnant. These cross-reacting proteins cause the HIV-antibody test to read positive or indeterminate (in the case of some Western Blots), even though the person is HIV negative. That's why we call it a "false-positive". Other tests can easily and definitively differentiate a true- from a false-positive (see below).

    2. Perhaps, although it has nothing to do with heredity.

    3. Why be scared of a false-positive test when you know you are HIV negative? Don't be a ninny. Will it happen again?: probably, but you already know what it is and how to differentiate a true- from a false-positive test, so this certainly should not be a deterrent to your having children! Frevinsakes!

    4. Why you? Lady, this does not only happen to you and it's no big deal. You are HIV negative. Stop whining over the limitations of the test and try having an ounce of compassion for the over 40,000,000 true HIV-positive folks (me included) who would love to have your problems!

    Dr. Bob

    false positive/can you explain?

    Aug 14, 2006

    during my pregnancy i was tested for hiv. the ELISA was positive and the western blot came back negative. ive been a blood donar for 3 years and never had a problem until i donated 6 months after i had my baby and they rejected me since the results for hiv 1/2 antibodies came back positive and the confirmatory came back inconclusive. i havent had any intercourse for more than a year so i couldnt have recently been infected. why is the conformatory still inconclusive? is there always going to be a false postive from now on? and is my baby going to have false postives as well?

    i recently donated to the red cross and they replied that i can no longer donate blood. my test results:





    what does this mean? am i HIV positve or negative? why does an indeterminate result occur? this never happened before when i donated. i had a baby 6 months ago. could this be the reason why? during pregnancy i was also tested for HIV and the ELISA was positive and the Wblot was negative. please help. im worried.

    Response from Dr. Frascino


    I've combined your two questions.

    You are HIV negative.

    Pregnancy causes a number of changes in the immune system and these changes can affect HIV-antibody-based test results. False-positive ELISA and/or Western Blot tests occur more frequently in women who are pregnant or who have had multiple pregnancies. Most often in these cases the Western Blot is indeterminate, as is the case with your test, rather than definitively positive. A non-antibody HIV test, such as a NAT or PCR, can be helpful to sort out true from false positives. Your NAT was negative. HIV is not your problem. No way. No how. OK?

    Stay well.

    Dr. Bob

  2. Basically what has to be remembered is that testing during surveys is a lot less rigorous that testing for individual diagnosis in for instance the USA.

    To be diagnosed HIV positive in the US, you have to have 2 consecutive positive ELISA (screening) tests, and 2 consecutive positive Western Blot (confirmation) tests.

    In surveys, only 1 or 2 screening tests are used. Western Blot is not used as a confirmation for positive screening tests.

    As a result, false positives are not corrected for in surveys. And anything that will cause a false positive (like pregnancy, but also malaria, vaccinations, etc.) will add to the total number of 'positives'.

    This is in my opinion the main reason that when surveys do not focus on pregnant women only, national prevalence rates are estimated to be much lower.

    Notice how this article from The Washington Post revises downwardly HIV rates in West and Central Africa, but maintains that the tests are correct when used in Southern Africa.

    How AIDS in Africa Was Overstated
    Reliance on Data From Urban Prenatal Clinics Skewed Early Projections

    By Craig Timberg
    Washington Post Foreign Service
    Thursday, April 6, 2006

    The example of Sierra Leone is most striking. Estimates were revised downward from 7% to under 1%.


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