A survey out yesterday, courtesy of the National AIDS Trust, has shown shocking levels of ignorance among old people and young on the subject of AIDS and HIV. About a fifth of the adult population could not identify “sex without a condom” (man/woman or man/man) as a way of getting HIV or AIDS. About a third could not identify that “sharing a syringe” might lead to infection. Only a handful (mostly women) knew that a breastfeeding mother could pass infection to her child.

Almost all the figures were worse than the last surveys in 2000 and 2005. Scarily, the group that seemed least clued up is the group in my age range, those who were subjected to relentless awareness campaigning back in the 1980s and early 1990s when people actually seemed to give a damn and Tom Hanks was in Philadelphia and everything. This is the group who are now raising their own children.

Why is sexual health awareness going backwards? How did we get so ignorant? How did so many of the children I went to school with just forget what was drummed into us all those years ago? These aren’t rhetorical questions. I want to know. This shouldn’t be happening. It is the stuff of despair.


Having said that, it is not surprising if some people are getting confused when sloppy reporting results in misinformation.

Take the Metro. Oh, how I despise the Metro. Today, they report that “the four main ways” that HIV is spread are: “unprotected sex, blood transfusions, shared needles and via breast-feeding” (my emphasis).

That is just wrong.

The NAT survey and press release did NOT suggest that breastfeeding is one of “the four main ways” that HIV is spread. What the survey did was to list possible transmission routes (e.g. “Blood transfusions”, “Spitting”) and participants had to say which were correct and which were false. Although the survey report did suggest that the four transmission routes mentioned were “key” and could itself have been clearer, it certainly did not say that these were the main ways of passing on HIV.

And anyone with any knowledge about this area – let’s face it, someone working as a health correspondent on a national daily newspaper ought to have some background knowledge – knows that breastfeeding is not a main way of catching HIV.

Breastfeeding can in some cases be a transmission route* , but it isn’t either fair or accurate to say it is among the top four risks.

[* Especially if appropriate precautions are not taken e.g. ensuring that breastfeeding is exclusive for six months, and that breast problems such as sore nipples or mastitis are treated promptly.]

For one thing (according to UNICEF) breastfeeding only accounts for about a third of parent to child infections – which is less than the number that occur during delivery (about half), so that right there is one way of spreading HIV that is more significant than breastfeeding.

More to the point, the problems of sexual transmission / infected needles / infected blood are much much bigger than parent to child transmission. Breastfeeding isn’t even in the same ballpark.

In fact, the dangers of denying breastmilk to children can be so serious, especially in developing countries where access to clean water and adequate supplies of formula is just not readily available, that they significantly outweigh the risks of infection.

One study in Africa showed that (a) the risk of a mother passing on HIV to her breastfed child is as low as 4% if the child is breastfed exclusively for six months and also (b) the mortality rate for exclusively breastfed infants was much lower than for exclusively formula fed infants: Fifteen percent of babies with HIV infected mothers who did not breast feed them died by age three months. Only six percent of babies who were only breast fed died at age three months.


Incidentally, when I visited the NAT site they had a survey: “Do you think Gordon Brown should make sex and relationships education compulsory in schools?” I think you can guess how I voted. 91% agreed.