AIDS and the news

Recently, this editorial appeared in the Washington Post:

Condom Sense
Pope Benedict XVI is wrong.
Washington Post Editorial, Thursday, March 19, 2009; Page A14

THE LATE New York senator Daniel Patrick Moynihan once said, "Everyone is entitled to his own opinion but not his own facts." This holds true even for the pope.

While on a flight to Cameroon on Tuesday to begin a weeklong journey through Africa, Pope Benedict XVI said, "You can't resolve [the AIDS epidemic] with the distribution of condoms. On the contrary, it increases the problem." In a perfect world, people would abstain from having sex until they were married or would be monogamous in committed relationships. But the world isn't perfect -- and neither is Pope Benedict's pronouncement on the effectiveness of condoms in the battle against HIV/AIDS. The evidence says so.
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Obviously, that is just a short piece of it, and you can read the rest of the article here:
http://www.washingtonpost.com/wp-dyn/content/article/2009/03/18/AR2009031803136.html

Why do I bother to mention this? Because I totally agree with the Pope on this one. Condoms are not the answer to the AIDS epidemic in Africa. In other places, perhaps they are, and in certain populations in Africa, like truck drivers and the prostitutes they frequent, they are the answer. But in the vast majority of cases, condoms are not going to solve the problem.

I'll tell you more about that in a minute. But first, I wanted to explain something that is not commonly known among people in the West. Before I came out to Mozambique, my cousin and I were having a discussion about WHY there is such an AIDS epidemic in Africa and why it hasn't spread so rapidly in America. Certainly there are lots of people having unprotected sex in America, but the epidemic really has been limited to high-risk populations for the most part, and education and condom use has really slowed the infection rate. Why has it taken off like a rocket here? Was malaria weakening the immune system of people so that they were more likely to contract HIV? That was one theory, but didn't account for its spread in areas where there is little malaria. Poverty certainly has its role to play in weakening people, or giving women few sexual rights. All those are factors, certainly. But in talking to our mission AIDS coordinator, who has a lot of on-the-ground experience with this, and with people here, especially missionaries who have been here a long time, I found that the answer is that many, many people have multiple sexual partners. In America, people tend to be serial monogamists. They have one parter for a number of months or years, then have another (Then there are those who abstain or who have only one long-term partner).

Here, one person will have several partners during the same time period, and each of those people have several. This spreads the virus much more rapidly. Women have few sexual rights, and this makes the problem much worse. It was hard for me to believe that this was going on at first, but unfortunately it is true.

So, why won't condoms solve this problem? Just pass them out to enough people, make them available for purchase, educate people about the risks, and the incidence will fall, right? Experience and research has shown that this is not the case.

Here's an excerpt from an interview was done by Christianity Today:
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Condoms, HIV, and Pope Benedict

Leading HIV researcher Edward C. Green says criticism of the pope 'unfair.'

Interview by Timothy C. Morgan | posted 3/20/2009 04:27PM

Edward C. Green is one of the world's leading field researchers on the spread of HIV and public health interventions. He's the director of the Harvard AIDS Prevention Research Project, and is a leading advocate for evidence-based interventions. He has been sharply criticized by some public health experts for supporting sexual partner reduction programs and for endorsing the so-called ABC method ("Abstain, Be faithful, or use a Condom") for fighting the transmission of HIV. After Pope Benedict's comments earlier this week, Green agreed to answer Christianity Today deputy managing editor Tim Morgan's questions by e-mail.

(Here is one question that he answered)
CT:Is there any country in Africa with a high HIV infection rate that has implemented new programs and seen infection rates fall? If so, what strategies are being followed?

EG:I'm glad you asked this. We are seeing HIV decline in eight or nine African countries. In every case, there's been a decrease in the proportion of men and women reporting multiple sexual partners. Ironically, in the first country where we saw this, Uganda, HIV prevalence decline stopped in about 2004, and infection rates appear to be rising again. This appears to be in part because emphasis on interventions that promote monogamy and fidelity has weakened significantly, and earlier behavior changes have eroded. There has been a steady increase in the very behavior that once accounted for rates declining — namely, having multiple and concurrent sex partners. There is a widespread belief that somehow Uganda had fewer condoms. In fact, foreign donors have persuaded Uganda to put even more emphasis on condoms.
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Here's the link to the whole article:
http://www.christianitytoday.com/ct/2009/marchweb-only/111-53.0.html

Why won't condoms solve it? Well, for one thing it doesn't address the behavior that is causing the problem, but also the vast majority of people simply won't pay for condoms, and even if given them, quite a few won't use them. When people are involved with multiple partners, then condoms are needed every single time, with every single partner, and this is realistically not something that is going to happen in an economically poor society. And women with little sexual power cannot force their male partners to use them (especially poor rural women whose husbands work in urban areas, returning for visits). There are all kinds of problems. This is not to say they should not be available, or not be distributed.

People in the West see the propagation of the "abstinence, monogamy" idea as an imposition of moralistic religious people on the culture of Africa. They believe that this idea suppresses people's sexual freedom, and therefore that we should encourage sexual freedom, and try to stem the tide through condom use. They forget that traditional African culture IS monogamous. It has been, in major part, the influence of the West that has caused the problems that are now occuring.

I encourage you to read the article in CT and investigate this matter further. In a later post, I'll talk about AIDS and our local situation. - Cami