Condom Lobby Drives AIDS Debate
Despite Abstinence Success in Africa
As AIDS sweeps across Africa, Uganda remains a lone success story, as millions
of Ugandans have embraced traditional sexual morality, including sexual
abstinence outside of marriage and fidelity within marraige, in order to avoid
infection. But the international AIDS community has been reluctant to promote
this strategy elsewhere, continuing, instead, to place its faith in condoms.
According to a US Agency for International Development (USAID) study of
Uganda, "HIV prevalence peaked at around 15 percent in 1991, and had fallen to
5 percent as of 2001.This dramatic decline in prevalence is unique worldwide."
USAID believes "The most important determinant of the reduction in HIV
incidence in Uganda appears to be a decrease in multiple sexual partnerships
and networks."
In comparison to other African nations, "Ugandan males in 1995 were less
likely to have ever had sex., more likely to be married and keep sex within
the marriage, and less likely to have multiple partners." USAID concludes that
"the effect of HIV prevention in Uganda (particularly partner reduction)
during the past decade appears to have had a similar impact as a potential
medical vaccine of 80 percent efficacy..A comprehensive behavior change-based
strategy.may be the most effective prevention approach."
However, the Ugandan experience is not being promoted elsewhere, which leads
some observers to conclude that ideology may be playing a role. In fact, as
news of the Ugandan success has spread, the defense of condoms has grown more
insistent.
Specifically, international AIDS activist have increased their attacks on the
Bush administration, which now seeks to incorporate abstinence training into
the US international AIDS program. Amy Coen, president of Population Action
International, recently stated that "the importance of condoms cannot be
overstated..Yet here in the United States, we are witnessing a retreat on the
part of the government and a wall of silence descending around condom use..The
case for condoms is indisputable." And, according to a column by Marie Cocco
in Newsday, "President George W. Bush has begun appointing critics of condoms
to a presidential advisory panel on AIDS. They include social conservatives
who question the international scientific consensus that condoms are highly
effective in AIDS prevention."
This promotion of condoms continues, despite the mounting evidence that they
have failed to stem the spread of the disease. For instance, led by Nelson
Mandela, South Africa has firmly embraced the "safe sex" strategy, and condom
use has increased. But South Africa remains the world leader in AIDS
infection, with 11.4 percent of its population currently infected.
The international AIDS community appears determined to find a technological
solution to the epidemic, rather than to suggest the types of behavior-change
that have succeeded in Uganda. On Tuesday, the Mercury News of Miami reported
that the Bill and Melinda Gates Foundation will spend $28 million to study the
potential of birth control diaphragms to combat AIDS in Africa. The Mercury
News cautions, however, that "the scientific basis for diaphragms preventing
AIDS is more theoretical than clinically proven."