Often during my dinners here at the University of Cape Town, I read. Eating and reading papers related to my research has become a much valued way to enjoy my meal. Tonight I read Frank Tanser’s paper about concentrated HIV epidemics within countries with generalized HIV epidemics. What this means is that even in countries, such as Namibia and South Africa, where HIV is well established in a substantial fraction of the population – at least one twentieth – one cannot exclude that everyone in the population who is HIV negative is equally likely to acquire infection. One of the prevailing trends is the disproportionately large risk of HIV in slum areas. Tanser’s group observed this in South Africa and I remember working on exactly this issue in 2012, when reviewing data on the HIV epidemic in Windhoek. From the study PharmAccess had done over the course of 2007-09, it was clear this was the trend in Windhoek was that of more infections in the informal settlements. Enter my research which will review HIV epidemiology among men who have sex with men in South Africa. Importantly, I will try to use information about sexual behavior of these men and their HIV prevalence emanating from studies in informal areas of South African cities. Can I then combine this information with information collected from women and men who report no sex with men, during household surveys in South Africa. Assuming the surveys took place across entire urban settlements, they will average over the risk behaviors in a city. Hence these heterosexual populations will appear to have a less risky sexual behavior profile compared to MSM, because one expects there to be more risk taking behavior in informal settlements, where investigators tend to collect data from MSM.
Implications for y modelling of the HIV epidemic in South Africa are then clear.