Monday, March 19, 2007

The HIV trial in Libya, part 4: How the infection must have occurred

This is continued from part 3 - the previous post ( Here, I'll try to keep my writing as short as possible and to use instead citations from people who know better. Two important terms, used below, are iatrogenic - caused by medical procedures, and nosocomial - acquired in a hospital; both terms refer to health damage, usually an infection.
Let's begin from the beginning: decades earlier and thousands of miles away from the Libyan "crime scene", a virus found a new host. The following citation is from
"Origin of HIV-1 Discovered
...Scientists at the University of Alabama at Birmingham (UAB) have discovered the origin of Human Immunodeficiency Virus Type 1 (HIV-1)...The researchers identified a subspecies of chimpanzee (Pan troglodytes troglodytes) native to West-Central Africa as the natural reservoir for HIV-1...The final piece of the puzzle was put in place when the researchers realized that the natural habitat for Pan troglodytes troglodytes overlaps precisely with the region in West-Central Africa where all three groups of HIV-1(M, N, and O) were first recognized. Based on these findings, Hahn and her colleagues concluded that Pan troglodytes troglodytes is the origin of HIV-1 and has been the source of at least three independent cross-species transmission events...While the origin of the AIDS epidemic has been clarified, an explanation for why the epidemic arose in the mid-20th century, and not before, remains a matter of speculation."Chimpanzees are frequently hunted for food, especially in West-Central Africa, and we believe that HIV-1 was introduced into the human population through exposure to blood during hunting and field dressing of these animals," says Hahn. She further believes that while incidental transmissions of chimpanzee viruses to humans may have occurred throughout history, it was the socio-economic changes in post-World War II Africa that provided the particular circumstances leading to the spread of HIV-1 and the development of the AIDS epidemic. "Increasing urbanization, breakdown of traditional lifestyles, population movements, civil unrest, and sexual promiscuity are all known to increase the rates of sexually transmitted diseases and thus likely triggered the AIDS pandemic," adds Hahn."
Dr. Hahn omitted one very important factor for spreading HIV: the health care system, which was practically not present in Africa until the 20th century. You think I am stretching my thesis too much? First, please read the following translation from the book "Sanu, bature" by Bulgarian zoologist Peter Beron. He describes his experience in Nigeria in 1976:
"Before returning to Bulgaria, we had to be immunized against cholera. There was a special immunization center in the town. However, before we went there, Dr. Malyavko (a Russian physician - M.M.) gave me three sealed disposable syringes and told me to insist that the local doctor uses them. I was hesitating - the doctor could be offended by such lack of trust. I went to the center with Kinka and Vladko (the author's wife and son, respectively - M.M.). In the street, there was an endless line. The doctor was sitting in front of the door and immunizing everybody with one and the same needle. These were prospective hajjis. They were preparing to travel to Mecca and the local Asclepius evidently thought that Allah wouldn't let any hepatitis creep into such pious Muslims. At that time, nobody knew about AIDS. Seeing us, the Asclepius called us and offered to immunize us immediately. I told him I had had polyo before and for that reason had to use a separate syringe. Vladko had been in contact with a person with hepatitis etc. The doctor showed full understanding. He unsealed the first syringe, injected Vladko, then injected Kinka with the second syringe and me with the third one. Then he, with my needle, continued injecting the long line of the candidate hajjis."
The case of the infected more than 400 Libyan children would be tragic even if it were exceptional, but unfortunately it isn't. We shall never know the exact number of AIDS victims throughout Africa and elsewhere whom medicine, instead of helping, failed, betrayed and doomed. The following citation (as well as others which I'll indicate by their PubMed identification numbers) is obtained from PubMed, a database of biomedical literature. PubMed abstracts and some full text articles can be accessed at
Gisselquist D. et al. (2003). Let it be sexual: how health care transmission of AIDS in Africa was ignored. PMID: 12665437
"The consensus among influential AIDS experts that heterosexual transmission accounts for 90% of HIV infections in African adults emerged no later than 1988. We examine evidence available through 1988, including risk measures associating HIV with sexual behaviour, health care, and socioeconomic variables, HIV in children, and risks for HIV in prostitutes and STD patients. Evidence permits the interpretation that health care exposures caused more HIV than sexual transmission... Preconceptions about African sexuality and a desire to maintain public trust in health care may have encouraged discounting of evidence."
Another work: Brewer D.D. et al. (2003). Mounting anomalies in the epidemiology of HIV in Africa: cry the beloved paradigm. PMID: 12665436. The citation is from, where the full text of the article is given.
"A number of these observations raise the question of an alternative route of transmission, for which medical care and the use of injections are prime candidates17,19-22. Prostitutes, for example, are often recruited for studies from STI clinics, where treatment is frequently given by injection, where non-sterile equipment is used with high frequency, and wherein the underlying prevalence of HIV is high7. Many studies that have assessed the impact of sexual activity on HIV transmission -notably those in Mwanza and Rakai, whose discordant results are still a subject of debate23-failed to consider the potential confounding effects of medical care in the propagation of HIV24.
Rapid HIV transmission in Africa has often occurred in countries with good access to medical care, like Botswana, Zimbabwe, and South Africa. For example, high rates in rural South Africa have paralleled aggressive efforts to deliver health care to rural populations. It is difficult to understand how improved access to health care, with its offers of public health messages, free condoms, and preventive services, would be associated with increased HIV transmission. Similarly, HIV prevalence is often higher in cities and among persons of high socioeconomic attainment than in rural areas or among less fortunate persons. Favourable access to health care is one of the differences that distinguishes between these groups."

In my recent post, I argued that sexually transmitted diseases shouldn't be regarded as God's punishment because they infect the innocent as well as the "guilty". In fact, it is worse - they infect first and foremost the innocent. Just read the following citation:
Gisselquist D. et al. (2004). HIV transmission during paediatric health care in sub-Saharan Africa--risks and evidence. PMID: 15034989
"Health care systems in sub-Saharan Africa are challenged not only to improve care for the increasing number of HIV-infected children, but also to prevent transmission of HIV to other children and health care workers through contaminated medical procedures and needlestick accidents. HIV-infected children aged to 1 year typically have high viral loads, making them dangerous reservoirs for iatrogenic transmission... This leads to high HIV prevalence among inpatient and outpatient children... Investigations of large iatrogenic outbreaks in Russia, Romania, and Libya demonstrate efficient HIV transmission through paediatric health care... In addition, several studies have reported much higher HIV prevalence in children 5-14 years old than could be expected from mother-to-child transmission alone."
So we are coming to the Libyan scene. The following citation, I think, illustrates well how the Libyan health care system initially reacted to the crisis - it focused efforts not on controlling the infection but on attempting to cover it up:
Kovac C, Khandjiev R. (2001). Doctors face murder charges in Libya. PMID: 11157524
"Nine Libyans, including the director of the Al-Fateh Hospital and the undersecretary of Benghazi's Department of Health, are charged with exposing 19 of the mothers of the infected children to HIV. They "hid the fact that the children were already infected" and failed to take prophylactic measures to protect the mothers... Ironically, according to a UNAIDS report, Libya has not supplied any information on AIDS cases in that country for 1998-2000."
In the same year, doctors in Switzerland analyzed the blood of infected children:
Yerly S. et al. (2001). Nosocomial outbreak of multiple bloodborne viral infections. PMID: 11443566
"After a major outbreak of human immunodeficiency virus (HIV) infection in approximately 400 children in 1998 in Libya, we tested HIV, hepatitis C virus (HCV), and hepatitis B virus (HBV) markers in 148 children and collected epidemiological data in a subgroup of 37 children and 46 parents. HIV infection was detected in all children but one, with HCV or HBV coinfection in 47% and 33%, respectively... The children visited the same hospital 1-6 times; at each visit, invasive procedures with potential blood transmission of virus were performed."
The finding of other blood-borne viruses in such a high proportion of the HIV-infected children supports the poor hygiene hypothesis, not the intentional infection hypothesis which lies so close to the hearts of Libyan prosecutors. Mention also that some children visited the hospital several (up to 6) times, so it is possible that they after being infected became secondary sources of infection for other young patients.
The next report is by Italian scientists:
Visco-Comandini U. et al. (2002). Monophyletic HIV type 1 CRF02-AG in a nosocomial outbreak in Benghazi, Libya. PMID: 12167281
"A cluster of HIV-1 infection has been identified in Libya in 1999, involving 402 children admitted to "El-Fath" Children's Hospital in Benghazi (BCH) during 1998 and 19 of their mothers... Out of this group, 104 children and 19 adult women have been followed at the National Institute for Infectious Diseases L. Spallanzani in Rome during 1 year. At BCH, all children had received intravenous infusions but not blood or blood products. A single child receiving a blood transfusion in 1997 and the 17 infected mothers were never hospitalized in Benghazi. In addition, two nurses were diagnosed as HIV-1 infected... The phylogenetic analyses showed that a monophyletic recombinant HIV-1 form CRF02-AG was infecting all of the HIV-1-seropositive patients admitted at BCH... A different strain was found in the child infected by blood transfusion."
Please mention that a child was infected in 1997 by blood transfusion with a different strain of HIV. This fact alone seems to disprove the claims of many Libyans that before the accused medics introduced the virus in 1998, there had been no HIV in Libya. Rather, the virus had arrived but the Libyan health care officials weren't ready to confront the threat and preferred to bury their heads into the sands of wishful thinking - our people aren't promiscuous, so it won't happen here...
The other noteworthy detail in this report is that the HIV strain is described as "recombinant". This English term can mean "product of natural recombination process" (as above) or "product of recombinant DNA technology (gene engineering)". Bulgarian journalists reporting from the Libyan courtroom said that the term was translated to Arabic and interpreted by Libyans in its second meaning only, i.e. that it was not a natural HIV strain but one modified by gene engineering. Hence, the infection must have been intentional. I don't know whether this misinterpretation was due to deliberate framing of the accused or to incompetence of the Libyan "experts". Let's not be paranoic and prefer the second explanation. In fact, the incompetence of some of the experts seems to be a public secret in Libya. Defense lawyer Byzanti at one point, after hearing reports of such experts accusing his clients, exclaimed, "But what scientists are they?". (The judge didn't like the remark.) If we talk seriously, even if the infection was intentional, it wouldn't make sense to use modified virus. If you intend to use a common cold virus as a bioweapon, you of course first have to modify it quite a lot, because the original virus is almost harmless. But why modify a virus which is lethal as it is? Just to leave a smoking gun at the crime scene? Why don't people use their heads, why are they ready to believe every nonsense they hear?
The next citation is from one of the most prestigeous scientific journals, Nature.
De Oliveira T. et al. (2006). Molecular epidemiology: HIV-1 and HCV sequences from Libyan outbreak. PMID: 17171825
"In 1998, outbreaks of human immunodeficiency virus type 1 (HIV-1) and hepatitis C virus (HCV) infection were reported in children attending Al-Fateh Hospital in Benghazi, Libya. Here we use molecular phylogenetic techniques to analyse new virus sequences from these outbreaks. We find that the HIV-1 and HCV strains were already circulating and prevalent in this hospital and its environs before the arrival in March 1998 of the foreign medical staff (five Bulgarian nurses and a Palestinian doctor) who stand accused of transmitting the HIV strain to the children."
No comment needed, I think.
The last PubMed citation I'll give is an appeal by Sidaction (I don't know this organization but its name is evidently derived from SIDA - AIDS in French):
Fleutelot E. (2006). 'Libyan Trial': a verdict running counter to scientific evidence. PMID: 17192180
"Sidaction denounces this trial as a parody of justice, which cannot hide the total incapacity of the Libyan Government to promote an appropriate politics of prevention and take care of people who are ill secondary to HIV infection-adults and children-in an appropriate way. It is useful to recall that the majority of Libyan people living with AIDS who are in need of an antiretroviral treatment can still not afford it."
It is easy to violate safety rules when working with blood and other human material under inadequate funding and supervision. I admit I have done it myself.
In recent decades reusable syringes, needles and other items were largely replaced by disposable ones. This was meant to assure safety, because sterilization of reusable equipment can always fail for some technical reason. However, as a result medical workers lost their expertise in sterilization and the good habit to perform it. So, when they are short of disposable equipment, they are quite likely to reuse it without even attempting sterilization or at least disinfection. Simple boiling would kill HIV without damaging most types of disposable equipment; but there must be somebody to do the boiling.
What exactly happened in Benghazi? Of course I cannot know exactly, but this is how I imagine it. The hospital has too many patients and too few syringes and needles. So, a nurse or a sanitary worker at the end of the day collects the used ones, soaks them in water and then washes them. Just washing, no sterilization. The boss hasn't ordered sterilization or disinfection. Trapped in the "good-people-don't-get-STDs" mentality, he cannot even think that the hospital's patients, these little angels, may have AIDS. But one child has it, contracted somehow outside the hospital. He is injected and then, when his syringe and needle are soaked, the virus contaminates all the other soaked needles. So other children, possibly dozens of them at once, are infected. The remaining virus in the hospital eventually dies out, it cannot reproduce outside the human body, but then one of the infected children comes for a new shot...
I would wish to end my post here, but I remember something I read on Highlander's blog:
"Whilst I’m sure many of them (medics-guest workers in Libya) honoured their contracts I can tell you from personal experience that some of them could not care less, and even the fact that US sanctions resulted in the deterioration of Libyan hospitals and that probably some Libyan health workers were also unscrupulous does not give the right to foreign workers to treat the Libyan patients like 'shit'. I’ve seen it as some of them ruled unconditionally in the hospitals and clinics, and you don’t want to be on their bad side as they may not treat you or worse may give you the wrong treatment. So again I wanted to say that not all of them were angels and saviours" (
Of course, among the health workers from any country some are not very good professionals, some are capable but not very polite, and even those who are both may have their bad days; besides, miscommunication because of language barrier can create impression of rudeness. This is not the point. The point, I think, is the implicit question behind the cited text: Was it a mere coincidence that the infection happened in a hospital with so many foreign workers? My answer: Maybe it wasn't. I must immediately state that this is not an admission that the defendants are guilty - there were dozens of other guest workers in the El Fateh hospital, while two of the accused had never worked there.
First, one of the most important factors pushing us to do good work is pressure from our clients. If we are health workers, this means that we shall work better if our relations, friends, neighbours or their children can become our patients any minute. If we are treating some completely unrelated people, we are more likely to take it easy. Remember, one of the other major iatrogenic AIDS outbreaks was among Romanian orphan children. The doctors and nurses immunizing them relaxed the safety rules because they knew their own children and their friends' children wouldn't be among the patients.
Second, a guest worker is unlikely to become a whistleblower. He'll prefer just to do what he is paid for and not risk trouble. Remember the Egyptian doctor who warned a Bulgarian nurse (in Part 2). However, he didn't warn the Libyan patients and the local community. The Bulgarian workers in fact couldn't do this even if they wanted, because they didn't speak Arabic. It was the journalists of the La magazine who first gave publicity of the outbreak, and they did get into trouble. They knew they were risking, but still wrote the article because they cared. They regarded it as their duty as citizens. So, before we all become true citizens of the world, it makes no harm to remember that only a citizen is likely to care.

Wednesday, March 14, 2007

The HIV trial in Libya, part 3: A tale of two idiotic states

This is the third part of my sequel; the first two parts are, respectively, at and (the trial is mentioned also in a number of other posts). Here, I'll try to tell how the accused medics were used as pawns in the unscrupulous chess games of Qaddafi and Bulgarian politicians.
Libya had been for decades the preferred (and often the only available) destination for Bulgarians willing to earn money as guest workers. Bulgaria and Libya as Socialist dictatorships were natural friends. Things began to change after 1989. Ordinary Bulgarians continued flocking to Libya, but the state policies became more pro-Western. In late 1991, the rightist government of Filip Dimitrov came to power and held it until the end of 1992. In order to move Bulgaria closer to the West, it condemned Libya as a state sponsor of terror. I liked this government, which I voted for, and still like it. I think it was right to condemn Libya. However, it was obliged then to discourage Bulgarians from going to Libya and to summon back the thousands of guest workers already there. Instead, the government "forgot" to inform the Bulgarian public about the move it had made! So the relations between Bulgarian and Libyan state became as bad as they could be without an official declaration of war, but Bulgarian guest workers in Libya were in happy ignorance of this important fact. If they knew it, possibly some would prefer to stay home.
As I wrote before (forgive me that I'm repeating some points from the previous part), when Libya made the first arrests of Bulgarian nurses in late 1998, the Bulgarian diplomatic missions "slept" and failed to intervene effectively. Later, there was much blame that Poland and the other nations whose nationals were arrested managed to release them and only Bulgaria failed. If we talk seriously, it is clear some country would fail, exactly as it is clear that in any sport contest there will be a loser. Qaddafi needed scapegoats and would get them, exactly as Scylla would take six men from every passing ship. (It is a curious coincidence that now, after Bulgarian doctor Georgiev was acquitted, the number of Qaddafi's victims is also six.) Even almighty USA felt unable to protect their citizens and, instead, prevented them from going to Libya.
I also don't know what exactly the diplomats had to do. I can't imagine myself being in their shoes and calling the Polish ambassador, "Hello, here is the Bulgarian ambassador. Colleague, could you please tell me how you got your medics released? Whom did you bribe, and how much?". So I don't blame the Bulgarian diplomats in Libya for not saving our arrested nurses; I blame them for apparently not trying to do this at all, for serving their own interests only and letting Bulgarian citizens in grave and undeserved trouble to save themselves.
After detained nationals of other countries were released and more Bulgarians were arrested, it became clear that local diplomacy was becoming powerless and intervention from Bulgarian government was needed (although still unlikely to succeed). At that time, Bulgarian government had other worries. There was war next door in Serbia and, to the horror of Bulgarians, our sky was being used by the NATO air forces and wayward NATO missiles were falling on our land (one hit a house in Sofia). The authorities had to deal with this.
However, the war ended and the Libyan problem could top the agenda. It didn't. Somewhen in the summer of 1999, I saw a head title in the 168 Hours weekly paper, Our nurse in Libya: I infected with AIDS intentionally. You could expect the public opinion to mobilize and force the government to act. It didn't happen. The efforts of the government (a rightist one, headed by Ivan Kostov) were focused on attempts to underestimate the seriousness of the case in Libya and to suppress the unofficial information that the arrested Bulgarians were being tortured and their lives were in danger. At some much later time, Ivan Kostov even said, "We mustn't just say that the accused Bulgarians are innocent. What if they are guilty?".
I had voted for this government and still find it, together with Filip Dimitrov's government, the best in our recent history. The non-Bulgarian reader here is likely to exclaim, "If these are your best governments, I wouldn't want to try your worst ones". And would be right. I wouldn't call my own state idiotic without a reason. Foreign minister in Kostov's government was Nadezhda Mihailova, a lady who did much harm to the Bulgarian democracy (Bulgarian readers know that I don't mean the Libyan case alone). She not only didn't hold to any moral principles, but evidently had too little intellect for the positions she occupied and used this intellect exclusively to enrich her family. Historians will (hopefully) reveal what brought her to the top of Bulgarian politics and kept her there for so long.
The wake-up call was an article about the process in the popular 24 Hours newspaper, titled Libya going to hang 6 Bulgarians?. It lingers in my memory that it was in late 1999, but checking the case's chronology, it is more likely to have been early 2000. The article reported that the six Bulgarians were charged with intentionally infecting Libyan children with HIV and the prosecutor was insisting for a death sentence. The public finally reacted and the government was forced to react as well.
What would I do if I were foreign minister at that time? I think I would speak loudly, bring the case to international human rights institutions, call the international media. This would most likely result in execution of the medics, but if we regard any hostage crisis from purely moral viewpoint, it's most important not to save the hostages but to avoid any appeasement of the hostage taker. Unfortunately, authorities more often follow the easy path and offer to the terrorist whatever he wants, just to have back the hostages. This of course only leads to more kidnappings.
There was another detail that determined our government's stance at that time. It was engaged in a "gas war" with Russia because of unwillingness to yield to insolent blackmail by Gasprom. Russia bought many of the Bulgarian media and the latter were attacking the government all the time. Most notably, it bought TV host Slavi Trifonov, whose show had a very large audience and was almost an institution. Now, the Libyan crisis came as a God's gift. All the pro-Russian, anti-government chorus began to sing, "The government must resign if the medics are executed". Satirical paper Starshel was one of the few sober voices. It wrote that whatever Bulgarian citizens thought about their current government, demanding its resignation in connection with the Libyan case would mean letting the Q-man decide who would rule our country. Unfortunately, nobody listened. Facing this internal crisis, the government naturally went to negotiate with Qaddafi, ready to make any concessions just to postpone the medics' executions till the end of its term!
Now, it's time for me to pay attention to the other idiotic state - Libya. On March 22, 2006, Highlander wrote, "If all the accused had been executed ages ago this story would not have dragged .... but then maybe they ARE innocent ?" ( While the end of the sentence is typical for Highlander, I believe many Libyans and other Arabs would put their signatures under its beginning. Many think that the Bulgarians are guilty and had to be executed swiftly. Dear friends and enemies, don't blame Bulgaria that it didn't happen. It was up to the Q-man. And can you guess why he didn't do it? One needn't be in MENSA to answer this question. Qaddafi wanted things from Bulgaria. He wanted it to entreat in the UN for lifting of sanctions. More importantly, he wanted money - for the Libyan budget and for his own deep pocket. So he and the Bulgarian government had a common interest to protract the case.
Initially I suppose Qaddafi intended to use the Bulgarians just to solve his PR problem. However, when Bulgarian government became active in early 2000, he realized that the detainees were hens bringing him gold eggs. He of course wasn't motivated either to release or to slaughter them. Over the years, the Libyan foreign debt to Bulgaria was reduced more than tenfold. Now, it's reported to be only about $ 50 million and Libya will never pay it, but will put the money in a charity fund for the infected children on behalf of Bulgaria. Besides, undisclosed sums of money have been paid over the years to Qaddafi fund, managed by his son Seif al Islam (the name means "sword of Islam"). This was the legal way for his dad to fill his private pockets. To offer some appeasement to the Bulgarian donors, Qaddafi played the good cop, bad cop game. He was the bad cop and Seif al Islam the good one. The latter repeatedly said that the epidemics must have been due to poor hygiene and the defendants most likely hadn't any intention to infect anybody with AIDS. These statements were clearly meant for export use and, I believe, are still largely unknown to the Libyan public. Also, Seif al Islam gave the green light to call Western AIDS experts as defense witnesses - a move his dad possibly regrets now.
Meanwhile, Bulgaria's position in the world changed. It used to be just a small, poor postcommunist country separated from civilized Europe by the Serbian battlefields. But it became NATO member and recently EU member. So mighty countries began to feel obliged to show solidarity with Bulgaria. The country used the situation and, after so many years of fruitless "quiet diplomacy", gave maximum publicity to the case.
I think that, as Qaddafi observed these changes, he had to jump off the train at some point. He could have the nurses convicted of negligence. Alternatively, he could use the other scapegoat - Palestinian doctor al Hajuj. It was the easiest thing to add an attempt to accuse innocent people for his own crimes to the already long list of charges against the poor man. So Qaddafi could close the case and have no problems. But he didn't, because he wanted more and more gold eggs. Greed never leads to anything good. Now, Qaddafi has no easy way out, pressed by the international community, on one side, and the Libyans, on the other. He has repeatedly stated in public that the Bulgarians are guilty and it isn't easy for him now to admit the opposite. Unfortunately, this means the defendants also have no easy way out.
To the decent Libyans who suffer as they see their country not only scorned but also laughed at by the Western world, I wish to say that such idiocies sometimes help. I am not the only one who thinks that the idiotic move of our dictator Zhivkov to rename the Bulgarian Turks in 1984/85 facilitated his toppling in 1989. But only God knows whether and when Libya will enjoy a similar event. So, those who believe could just say a prayer for all in this case who deserve it - the accused Bulgarians and Palestinian and their families, the infected Libyan children and their families and, most importantly, the uninfected Libyan children.

Thursday, March 08, 2007

God and sexually transmitted diseases

This post is inspired by a discussion on Highlander's blog. On, she wrote, "...Even following treatment for AIDS, it will still be found in the semen and is capable of replication and infection of body cells again... Which led me to wonder whether the scriptures have been right ? Is that why all 3 monotheistic religion have always advocated chastity and the prohibition of fornication and adultery? Could it be their method of warning us about this killer disease in a way that is graspable by our limited psyche /knowledge 2000 years ago, and so have to disguise it as based on morality? How to inculcate morality in us? One husband per wife ? family virtues etc…"
I commented, "...Chastity norms meant to secure a stable family as a base of the society, rather than to protect people from STDs. If God didn't want us to die of AIDS (and of other STDs - syphilis has for centuries been as lethal as AIDS is today), why didn't He give humans natural immunity against pathogens causing STDs?"
Highlander replies, "You cannot explain to people of a certain mindset about STD so you tell them to be chaste because that is a virtue etc..But then you create STDs so that the ahem no offense meant 'unchaste' gets it . whether is is Syphillis , AIDS or simple chlamydia infection which can cause such havoc though right ? That's how God tests our strenght because it is difficult to overcome desire and humankind will be human after all :P."
I'll cite also two other bloggers who posted relevant comments.
The Lost Libyano: "Who said god didnt want people to die from AIDS. Quite the contrary he sent it to kill people, millions of people, just like he sent syphilis, and just like he sent the black plague, which wiped out 2/3 of Europes population, and he will send much more. "
Um Haleema: "I wonder what message he was trying to send to the babies born with aids and innocent 'pure' people that get aids through blood transfusions."

After this introduction of citations, I'll continue with new text.
The original Highlander's post didn't quite clarify what she thought about the origin of STD-causing pathogens. Has God set rules to protect us from germs created by someone else, e.g. the devil? Or are these germs created by God himself to punish us if we neglect His rules? Then, in the comment, Highlander was explicit that it was God who created the pathogenic bacteria and viruses.
Diseases definitely are an important theological problem. Most believers think that they are trials God sends to us. When this cannot apply, most notably when a young child has a fatal disease, they think that for some reason unknown to us God needed to take the child back right now. Although this is not my view, I generally like it because it doesn't label the sufferer as a sinner.
However, about sexually transmitted diseases (and occasionally about other infectious diseases, such as the plague) some believers think they are God's punishments. Notably the puritans. I wonder how many puritans, Highlander included, can be such wonderful, good and tolerant people while admiring such a nasty God.
While do I find this God nasty? First, because he has invented germs to punish people having unauthorized sex but nothing specific to punish true villains. There are no germs for murderers. What am I supposed to think of a God who finds making love worse than killing?
Second, because STD-causing pathogens don't punish just the "sinners". They are not precision bombs. They are weapons of mass destruction. They infect the innocent as well as the "guilty". If a rapist has a STD, he will transmit it to his victim. If an adulterous husband contracts HIV, he'll later infect his wife, even if she has never had sex with another man. And if they conceive, the baby will very likely be infected, too. Among other sexually transmitted diseases, Highlander mentioned the chlamydia infection. But if we call the pathogen by its full name, Chlamydia trachomatis, we'll imagine another picture: children who hopelessly scratch their eyes burning from pain and gradually lose their vision (see e.g.
Third, God hasn't saved all these goodies for humans. He has created STD-causing pathogens also for other species, where chastity (and other moral categories) simply makes no sense. In fact, HIV-1 and 2 are evidently viruses of non-human primates which recently discovered us as a new host species. So, if we are to regard AIDS as God's punishment (which I don't recommend), it is rather a punishment for invading and destroying the last remaining habitats of our little brothers.
I wonder how people can live under such a God and still enjoy life. I would be rather depressed. It seems much worse than living under Qaddafi. Of course, where the majority of people have a God like this one, they also tend to have a ruler like Qaddafi. But if you live under a dictator, you can attempt emigration, dream of a revolution or simply remember that sooner or later he will die. None of this applies to God. You cannot escape Him even by suicide.
Still, there is a way out. You could, like the girl in the Labyrinth movie say, "You have no power over me", and find a gentler God. Mine would be one who loves equally all His creatures. When they clash, He doesn't intervene and lets them have a fair fight. However, this would be just a biologist's God. Other people are likely to prefer a tyrant God to one who holds HIV and treponema as close to His heart as humans. Besides, all religions I know explicitly postulate a special status for the human species.