Monday, October 10, 2016

Beyond the Cut Hunter: A Historical Epidemiology of HIV Beginnings in Central Africa

 2016 Oct 7. [Epub ahead of print]

Beyond the Cut Hunter: A Historical Epidemiology of HIV Beginnings in Central Africa.

Author information

  • 1Department of Anthropology, City University of New York - Lehman College, New York, NY, USA.
  • 2Ministry of Agriculture and Rural Development, Yaound√©, Cameroon.
  • 3Emerging Diseases Epidemiology Unit, Institut Pasteur-Paris, 25-28 Rue du Docteur Roux, 75724, Paris Cedex, France.
  • 4Emerging Diseases Epidemiology Unit, Institut Pasteur-Paris, 25-28 Rue du Docteur Roux, 75724, Paris Cedex, France. tamara.giles-vernick@pasteur.fr.
  • 5Canadian Institute for Advanced Studies, Toronto, Canada. tamara.giles-vernick@pasteur.fr.

Abstract

In the absence of direct evidence, an imagined "cut hunter" stands in for the index patient of pandemic HIV/AIDS. During the early years of colonial rule, this explanation goes, a hunter was cut or injured from hunting or butchering a chimpanzee infected with simian immunodeficiency virus, resulting in the first sustained human infection with the virus that would emerge as HIV-1M. We argue here that the "cut hunter" relies on a historical misunderstanding and ecological oversimplification of human-chimpanzee (Pan Troglodytes troglodytes) interactions that facilitated pathogenic transmission. This initial host shift cannot explain the beginnings of the HIV/AIDS pandemic. Instead, we must understand the processes by which the virus became transmissible, possibly between Sangha basin inhabitants and ultimately reached Kinshasa. A historical epidemiology of the late nineteenth and twentieth centuries, provides a much-needed corrective to the major shortcomings of the cut hunter. Based on 62 oral historical interviews conducted in southeastern Cameroon and archival research, we show that HIV emerged from ecological, economic, and socio-political transformations of the late nineteenth and twentieth centuries. The gradual imposition of colonial rule built on and reoriented ecologies and economies, and altered older patterns of mobility and sociality. Certain changes may have contributed to the initial viral host shift, but more importantly, facilitated the adaptation of HIV-1M to human-to-human transmission. Our evidence suggests that the most critical changes occurred after 1920. This argument has important implications for public health policy, underscoring recent work emphasizing alternative pathways for zoonotic spillovers into human beings.

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