in South Africa are being infected with HIV through
dirty needles, experts have claimed.
suggested hundreds of thousands of children may have
contracted the virus in this way.
The study is the
latest to point to contaminated needles as a major cause
of HIV in Africa.
believe as many as 40% of HIV infections in African
adults are linked to injections.
agencies have rejected this theory, saying most cases
are linked to unsafe sex.
Officials have also
warned that the theory could damage campaigns to get
people in Africa to use condoms to protect themselves
from the disease.
This latest research
looked at a study carried out by the Human Sciences
Research Council of South Africa, published last year.
It revealed that 5.6%
of South African children between the ages of two and 14
have HIV. This represents 670,000 children.
However, figures for
mother-to-baby transmission - believed to be the main
cause of HIV in children - are substantially lower.
This suggests children
are contracting the virus in another way.
Researchers from the
University of Tübingen in Germany said the findings
indicated contaminated needles were to blame.
They rejected claims
that children could have contracted HIV through unsafe
sex or as a result of abuse.
Writing in the Journal
of Obstetrics and Gynaecology, they said: "For
hundreds of thousands of South African children to have
acquired HIV sexually, inordinately high levels of
childhood sexual exposure would be required, a
phenomenon unlikely to have been overlooked by
paediatricians. Recent reports from South Africa
discourage this hypotheses."
The researchers also
examined other studies. They said these also showed
differences between HIV rates in children and the number
of mother-to-child transmissions.
They said the findings
showed unsafe sex was no longer the main cause of HIV in
belief that HIV transmission in Africa is driven by
heterosexual exposure is no longer tenable," they
mounting evidence that rapid HIV transmission is fuelled
by parenteral exposures in health care settings,
especially medical injections but also including
transfusion of untested blood and others.
"Not only are
injections popular among African patients, administered
at an estimated 90% of medical visits, but also often
unnecessary and injection equipment is often used."
The researchers said
urgent action is needed to improve standards in South
educate their patients in the dangers of non-sterile
injections and ensure that their own practices are
They said the findings
could also be applied to other countries on the
"We must protect
patients from their own medical care system in all
countries with similar epidemiological
South Africa has the
largest HIV population in the world - one in five people
However, the South
African government rejected claims children were
contracting HIV through dirty needles.
Dr Nono Simelela, head
of its national HIV and Aids programme, told BBC News
Online: "I have worked in clinics and hospitals in
various part of our country - including some that were
really poorly equipped.
"But nowhere have
I seen practices that would make me conclude that dirty
needles are the most probable explanation for this
surprising rate of HIV-infection in children. And I am
confident my doubts would be shared by many other
"I believe the
matter needs to be much more closely interrogated before
we form conclusions about the cause."