The fight against HIV/AIDS has largely focused on sexual behaviour while little attention is paid to other avenues of transmission like shared shaving machines or a traditional healer's scalpel.

While it is acknowledged that the majority of HIV infections occur through sexual liaisons, there is a significant number that might have got the virus through other means like unsafe use of razor blades and shaving machines.

In Russia, public shaving was once banned as there were fears that hygiene standards at most barber shops were inadequate, hence there is a high risk of spreading HIV via dirty blades and machines.

In Botswana, barbers might have lost a substantial number of clients who fear contracting the virus through unsterilised shaving machines. "One day, I was waiting in a queue at one of these makeshift barber shops when I noticed that one client had sores all over his head. I immediately went away and bought my own shaving equipment. Up to this day, I shave at home," said Lameck Myengwa, the Selebi-Phikwe District AIDS Coordinator.

There are fears that a majority of people visiting barber shops do not check if the shaving equipment is sterilised.

"I never bother to check even though it is a reality that you can contract HIV through unsafe use of blades," Mpho Kebalepile, a Selebi-Phikwe resident said. He is not alone in this predicament.

While Kebalepile uses an established salon in town, 32-year-old. Michael Kota cannot afford the relatively high charges at such barber shops. Instead, he treks to the nearest makeshift barber shop under a tree at Distance location. The prices are relatively low though the hygiene is not up to standard. "I do not have a choice, although my health comes first. These guys (barbers) use methylated spirit to sterilise their blades. I do not know how effective it is," Kota said.

Questions have been raised as to the effectiveness of using methylated spirit for sterilisation. Research shows that 70 percent of industrial methylated spirit and ethanol are ineffective against dried HIV. Some barber shops in Selebi-Phikwe do not sterilise shaving machines even with methylated spirit. "We know we should sterilise the equipment. But in our case, the owner of the salon has not bought new equipment since the machine we have broke down. We have no option but to use methylated spirit and honestly I can't tell you how safe it is," said one barber, speaking on condition of anonymity.

Callistus Kolantsho, a local journalist said it is imperative that barbers sterilise their equipment. He admitted that he never inquires about the sterilisation of shaving machines before having a hair cut. "I have never asked if they sterilise, but what I know is that the majority of the barber shops do not sterilise their equipment," Kolantsho said.

He said a good option is to buy shaving equipment and shave at home, but regrettably, some people do not know how to use the shavers.

"Even if the shaving equipment is sold in shops, some of us do not know how to use it. It is crucial that people are sensitised about the possibility of contracting HIV at salons. This is an issue of national concern," Kolantsho said.

He lamented that focus has been more on sexual behaviour, neglecting other possible avenues of transmission. Rural dwellers might be at the greatest risk as unsafe shaving methods are still used. "You find that people in remote areas still use the same razor blade over and over again and that poses risks. There is need for a sustained campaign to raise awareness," Kolantsho said.

District AIDS Coordinator, Myengwa said that focus has been on sexual behaviour, compared to other avenues of transmission. "I don't remember us targeting that area (barber  shops). I believe it is an area that we have neglected. We have been focusing on behaviour change and condom distribution. We really need to look at that (barber shops)," he said. He explained that there are partners who work on community mobilisation and they should probably pay more attention to barber shops. He urged barber shops to sterilise their equipment because methylated spirit might not be sufficient. "I doubt if the methylated spirit effectively kills bacteria. Community mobilisers should visit barber shops and check their practice," Myengwa said.

In countries like Cameroon, the United States and India, barbers are central in HIV/AIDS campaigns.