Sir, - Paul Cullen (The Irish Timers, July 15th) is to be congratulated for not mincing his words about the HIV epidemic in Africa. He is correct in stating that no cure has yet been found for AIDS. We have managed to convert it into a chronic condition in this part of the world with a cocktail of drugs which have often had serious side-effects and which need constant, sophisticated monitoring. But the virus mutates and people, no matter how rich, are still dying of the disease.
Poverty makes all illnesses worse but President Mbeki of South Africa is not helping anyone by saying it is the cause of AIDS. Lack of education and cognisance of how the disease is spread are even more important. The prevention of HIV infection, as Dr Mike Meegan says, is vital. Why have we become so coy about discussing the sexual transmission of HIV infection in Africa? Is it because women there have so little say about their sexual lives and we don't want to admit it?
"In rural, male-dominated African communities, women's sexual initiation comes early and sometimes forcibly," Paul Cullen writes. This happens in urban areas too, where middle aged "sugar daddies", as they are called, knowing that teenage girls are less likely than older women to carry the infection, pay the girls' school fees in return for sex. This contributes to the statistic that in some areas six times as many teenage girls as boys are infected.
With Mary Banotti MEP and Eoin Ryan TD, I went to Uganda and Zambia earlier this year. It was depressing to hear laughter from some male politicians when female politicians said that rapists who knew they were HIV positive should get sentences longer than those normally imposed. There was little concern about the spread of HIV infection from husbands to wives - this was considered bedroom politics. Yet it is leading to the steady increase in HIV positive tests at antenatal clinics.
Of course not all is gloom: the simple treatment which greatly reduces the spread of HIV from mother to baby is to be welcomed, but the drawback is that in the long run it may make it more difficult to treat the mother, leaving another little orphan.
Concentrating solely on the cost of the drugs really is not helpful. The Trade-Related Intellectual Property agreement should mean that necessary drugs can be produced at a cheap price in these countries. But the infrastructure to administer them simply does not exist in the worst affected countries.
Ignorance about the methods of spread must be addressed. The practice of "dry sex" in parts of Africa - whereby the woman puts powdered bark and herbs in her vagina, supposedly to increase male pleasure but causing bleeding and increased risk of HIV spread - is rarely mentioned, even though African women tell me it is common. As one tribal elder in Uganda said: "If traditional practices are dangerous, traditional practices must change."
There are many people in Africa who are getting to grips with the spread of this infection. They know the best way to give information to their own people; and we would be better asking them what they want us to do rather than sending in our Western solutions which have had little effect to date. To end on a cheerful note, we did think that the Irish aid workers were some of the best people we met at doing just that - asking for advice from the locals on how to help rather than telling them what to do. - Yours, etc.,
Senator Mary Henry, Seanad Eireann, Dublin 2.