AIDS in Africa: A bioanthropological perspective

The epidemiological characteristics of acquired immunodeficiency syndrome (AIDS) in Africa are reviewed. Infection rates with human immunodeficiency virus 1 (HIV-1) and human immunodeficiency virus 2 (HIV-2) vary across the continent of Africa with the highest infection rates occurring in East and Central Africa. The primary pattern of infection with HIV-1 is characterized by high rates of heterosexual vs. homosexual transmission, a low male to female sex ratio of cases, and high rates of pediatric AIDS. Cultural anthropologists have emphasized variation in human sexual behavior as an important factor in understanding the HIV epidemic. These studies have focussed on understanding the range of sexual risk behaviors present in different cultures and the cultural meanings of these behaviors. Biological anthropologists approach the study of human disease with an interest in human biological variation, evolutionary models, and the interface between biology and behavior. A Bioanthropology Research Agenda for AIDS is proposed which focuses on these three areas. Potential research domains for biological anthropologists include: human biological variation and cofactors of infection and disease, the evolutionary impact of HIV infection, and the interface between biology and behavior and the biological impact of behavior. Working with colleagues in other disciplines, biological anthropologists can assist in furthering understanding of the variables of HIV infection and disease.