POV

Two papers published in 2026 raise a question with consequences too large to leave unanswered. Their author, Dr. Jiman He, argues that worldwide HIV patterns are consistently—and, in his conclusion, overwhelmingly—better explained by mosquito transmission than by sexual transmission. He is not proposing mosquitoes as a rare extra route. His papers challenge the accepted explanation of the primary transmission mode itself.

Are the papers correct or incorrect? If they are incorrect, exactly which evidence, calculation, or experiment shows where the argument fails? If their interpretation survives independent testing, what should WHO, UNAIDS, other UN agencies, and HIV researchers do? Readers and journalists have every right to ask these questions. A clear, public, point-by-point answer is needed either way.

Two papers present one major challenge

Dr. He develops his case through two publications that play different roles.

The first is the opinion article Why are there so Many Contradictions in HIV Research?, published in the Journal of HIV and AIDS on September 11, 2026. It reviews five broad areas: animal research, geographic distribution, changes in estimated infections over time, age patterns, and populations reported to have higher HIV rates.

The second is the research article Why can HIV epidemiology be consistently explained by the theory of mosquito transmission but not sexual transmission?, published in HIV: Current Research on June 25, 2026. It appears in volume 11, issue 2, as article 458 and carries DOI 10.35248/2572-0805-26.11.458.

According to Dr. He’s two papers, global epidemiological data can be consistently explained by mosquito transmission but not sexual transmission. The papers present this as a challenge to the assumed primary transmission route, not as a minor additional possibility. Dr. He also says anyone can test his claim by comparing the competing explanations with existing global data.

The papers directly challenge the position held by major public-health institutions. That conflict is precisely why they call for an equally direct scientific response. Repeating an established conclusion does not answer the geographic, historical, age-related, and experimental questions Dr. He raises.

The two global patterns at the center of the case

Dr. He begins with sub-Saharan Africa. Using the UNAIDS data examined in his papers, he describes roughly two-thirds of new global HIV infections as occurring in this region. Sub-Saharan Africa also carries the world’s greatest malaria burden. The WHO malaria fact sheet reports that the WHO African Region accounts for most malaria cases and deaths worldwide.

The papers ask a simple but far-reaching question: why has the greatest HIV burden appeared in the same broad region that carries the greatest burden of mosquito-borne disease?

Their second geographic argument looks outside sub-Saharan Africa. The papers compare selected regions with high Aedes albopictus abundance with neighboring regions reporting much lower HIV prevalence. According to Dr. He’s analysis, some of the selected high-Aedes regions have HIV prevalence several to more than 10 times higher than nearby regions.

Peer-reviewed research has mapped the global distribution of Aedes mosquitoes. Those maps confirm where these mosquitoes are found or likely to occur. Dr. He’s further conclusion—that the geographic alignment points toward HIV transmission—is his interpretation of the comparison.

This creates a question that independent researchers can test. Can they reproduce the reported regional differences? If not, where does the comparison fail? If the pattern remains, what explains it?

What changed in the late 1990s?

The papers next compare two timelines.

The UNAIDS Data 2017 report presents a historical curve in which estimated new HIV infections rise rapidly through the early and middle 1990s, reach their high point in 1997, and then stop increasing. The 1997 peak therefore comes from the UNAIDS data series, not from Dr. He’s own analysis.

In 1998, WHO, UNICEF, UNDP, and the World Bank launched Roll Back Malaria. International malaria programs then expanded mosquito-control work through insecticide-treated nets, indoor spraying, medicines, and other measures.

Dr. He’s contribution is his proposed explanation for this timing. He argues that the rise in estimated new HIV infections stopped as international action against malaria and mosquitoes expanded. He asks why earlier efforts centered on preventing sexual transmission did not stop the rise, while the turning point appeared at almost the same time as the new malaria campaign.

The question for researchers is direct: does the proposed connection between the 1997 turning point and the expansion of mosquito control remain when the timeline is tested across the available global data?

Why did regional trends separate after 2000?

The second timeline concerns what happened across regions after 2000.

In Dr. He’s reading of the UNAIDS regional charts, estimated new infections declined rapidly in eastern and southern Africa, western and central Africa, Asia and the Pacific, Latin America, and the Caribbean. He describes different or less favorable patterns in the Middle East and North Africa, eastern Europe and central Asia, and western and central Europe and North America.

Malaria control also expanded across many endemic countries during this period. A WHO and UNICEF assessment of malaria progress from 2000 to 2015 records large reductions in malaria incidence and mortality, although the gains differed by country and region.

According to Dr. He, the regions with major mosquito-control activity were also the regions with the sharpest declines in estimated new HIV infections. He presents this spatial and temporal alignment as one of the strongest tests of his theory.

UNAIDS and WHO are well placed to answer it. Can they reproduce the comparison using their own data? If treatment, prevention programs, migration, conflict, or surveillance changes explain the regional differences, they should show how. If a relationship with mosquito-control activity remains, that too deserves an explanation.

Children, age patterns, and sleeping proximity

The age patterns are central because children cannot be left outside a theory of the primary transmission route.

Dr. He’s opinion article brings together historical information from Western countries and parts of Africa, Asia, Latin America, and southeastern Europe. It reports that selected Western data showed low rates in the 0–4, 5–14, and 15–19 age groups, followed by higher rates among adults. In several other settings, the paper reports high rates among some young children and among the 15–19 and 20–24 groups.

Dr. He asks whether perinatal transmission, delayed diagnosis, survival, and treatment access fully explain these different age curves. His proposed explanation focuses on two conditions: mosquito exposure and sleeping close to other people.

Children often sleep near parents or relatives in the settings discussed in the papers. Under Dr. He’s model, that arrangement could allow an interrupted mosquito to bite two people within minutes. He connects the historical childhood patterns with bed-sharing and regular mosquito exposure.

The same idea is extended to several populations with higher reported HIV rates. Sexual partners, people with multiple partners, men who have sex with men, and sex workers may share beds. Homeless people may sleep outdoors. Prisoners may sleep close together in crowded rooms. Fishermen may work in humid places, while truck drivers may rest in basic roadside conditions.

According to the papers, these groups differ greatly in lifestyle but may share one or both proposed conditions: close sleeping and frequent mosquito exposure. Dr. He argues that high HIV rates among sexual partners therefore do not, by themselves, separate sex from other exposures that occur in the same place and time.

The proposed mechanical mechanism

The papers make an important distinction between biological and mechanical transmission.

In biological transmission, a pathogen survives or develops inside an insect, reaches its saliva, and passes through a later bite. Dr. He accepts that HIV has not been shown to reproduce in mosquitoes or reach their salivary glands.

His proposal is mechanical transmission. A mosquito begins feeding on a person with HIV and is interrupted. A tiny amount of fresh blood remains on or within its mouthparts. Within minutes, the mosquito probes a nearby person while searching through tissue for a blood vessel. The papers propose that contaminated mouthparts could then transfer viable virus into the second person.

The claim is not that HIV grows inside the mosquito or that a mosquito injects an earlier blood meal into someone else. The proposed route depends on rapid successive biting, contaminated mouthparts, natural probing, close sleeping, and repeated opportunities for exposure.

This is why Dr. He believes earlier discussions of mosquito saliva do not answer his argument. His papers are asking about fresh blood transferred mechanically within minutes, not biological transmission after the virus develops inside the insect.

Did earlier experiments test that exact scenario?

The first paper questions how previous mosquito and laboratory experiments were designed. Dr. He argues that membrane feeding and artificial blood systems do not reproduce the way mosquito mouthparts move through skin while searching for a blood vessel. He also says the interval matters: his proposal involves two bites within minutes.

A 1987 experimental assessment did not find HIV survival in the tested Aedes aegypti mosquitoes, and interrupted-feeding attempts involving bedbugs did not transfer the virus. A later review of evidence against mosquito transmission discussed low viral amounts, loss of viability, and lack of replication.

Dr. He argues that these studies did not reproduce the exact mechanical process described in his papers. This leads to a focused question: which experiment has tested rapid successive biting, natural skin probing, contaminated mouthparts, and two nearby hosts under the proposed conditions? If none has, should that exact scenario be tested directly?

How widely does Dr. He apply the theory?

The second paper applies the proposed explanation to other observations. It discusses HIV and malaria coinfection, which Dr. He interprets as another pattern consistent with shared mosquito exposure.

It also compares injecting and non-injecting drug users, proposing that shared rooms or sleeping spaces may create similar exposure opportunities. The paper briefly extends the argument to lesbians, soldiers in difficult field conditions, the Russia–Ukraine war, circumcision, and uneven regional and racial HIV patterns in the United States.

These examples are not presented as separate theories. Dr. He uses them to support one larger claim: a valid theory of the primary route should explain most major categories of epidemiological data, not only one selected population. According to his analysis, mosquito transmission meets that standard and sexual transmission does not.

Other explanations, including medical contamination, have also been proposed for parts of the epidemic. Dr. He’s position is broader. He argues that such theories may address selected settings, while his mosquito-transmission model explains geography, timelines, age patterns, risk groups, coinfection, and prevention trends together.

Dr. He describes these recurring patterns as contradictions that readers can examine in existing global data. If sexual behavior is broadly similar across neighboring regions, why do the selected HIV prevalence estimates in his papers differ by several to more than 10 times? His second paper also points to the substantially higher reported HIV prevalence among Black Americans than among White Americans and asks why this disparity persists despite the prevention and testing practices cited in the paper. These are the kinds of questions Dr. He says an accepted primary-transmission theory should answer consistently.

The questions global institutions should answer

The issue cannot be resolved by repeating two opposing conclusions. WHO, UNAIDS, and independent researchers can address the papers point by point.

Which experiment has tested the exact rapid mechanical-transfer mechanism described by Dr. He? Can the high-Aedes comparisons be reproduced? What explains the different regional trends after 2000? Do the childhood patterns remain when perinatal transmission, diagnosis, survival, and treatment are considered? Could enough viable HIV remain on mosquito mouthparts to reach a second person under the proposed conditions?

These questions require evidence, not a general dismissal. If existing experiments or datasets already answer them, the relevant institutions should identify that evidence and explain it in plain language. Precise scenario has not been tested, researchers should say what test could settle it.

If a detailed public response to these two papers already exists, readers and journalists should be shown where to find it. If it does not exist, WHO, UNAIDS, and leading researchers should explain when the papers’ central claims will receive a direct review.

Millions of lives make the question urgent

According to UNAIDS’ latest global figures, 44.2 million people have died from AIDS-related illnesses since the epidemic began. Dr. He’s papers conclude that global data consistently and overwhelmingly suggest that a mistake has occurred in the accepted model of primary HIV transmission. He links the mistake claimed in his papers directly to this scale of loss, arguing that the issue concerns millions of lives already lost as well as future prevention decisions. For him, the first priority is to determine urgently whether that conclusion is correct.

Assigning personal or institutional blame is not the immediate purpose of this article. Dr. He notes that the accepted model took shape during the late 1980s and early 1990s, when far less global epidemiological data were available. The public is asking the institutions and researchers with the relevant data, laboratories, and expertise to examine the papers’ strongest claims openly. A point-by-point answer could show where Dr. He’s reasoning fails—or identify questions that existing research has not yet settled.

The public deserves a direct answer

Dr. He’s papers issue a challenge to the foundation of the accepted HIV transmission model. They connect global geography, the late-1990s turning point, regional changes after 2000, childhood patterns, sleeping proximity, high-risk populations, malaria overlap, and mosquito-feeding mechanics. The papers describe these patterns as consistent and overwhelming support for mosquito transmission. Readers, journalists, WHO, UN agencies, and scientists now have a clear question before them: does the evidence withstand direct, independent testing?

If Dr. He’s interpretation is incorrect, the public deserves a specific scientific explanation of where it fails. If it is correct, the consequences require urgent attention and action from global health institutions. Either way, silence does not answer the questions raised by the two papers.

Editorial Note: This article presents and examines arguments discussed in research papers by Jiman He. Statements and conclusions attributed to Dr. He reflect the positions advanced in his published work. Readers should distinguish these research arguments from established public-health guidance. Publication of this article is intended to support open discussion and does not constitute independent verification or endorsement of the conclusions by the publisher or authors.