Two weeks ago, Ugandan president Yoweri Museveni gave a speech at the International AIDS Conference in Bangkok which led to his being excoriated by the international media. AIDs activists and media pundits worldwide criticized him for making what they believed to be an outrageous and unsubstantiated assertion. What could he have said to draw such ire? Musevani had the audacity to claim that that abstinence and partner reduction was more effective than condoms in fighting HIV.
While this might appear to be a common sense notion to most intelligent people, it was denounced as a policy based “more on politics than on science and public health.” The critics contend that there is a lack of scientific evidence that abstinence and partner reduction programs work, apparently unaware that not having sex is a powerful impediment to the transmission of a sexually transmitted disease.
In an editorial criticizing both Musevnai and President Bush for promoting changes in sexual behavior rather than condom use, Newsday columnist Joseph Dolman provides a glimpse into the mindset that holds this belief:
But let's face it, gents. It's a crazy world out there. It's one thing to mouth truisms about HIV transmission. It's another entirely different to apply those truisms effectively and wisely across a broad swath of humanity.
So I arrive at a question: Have you two fellows gone completely nuts? I raise this point because last week Museveni roiled the 15th International Conference on AIDS in Bangkok, Thailand, when he said that it's more important in the fight against the disease to change sexual behavior than it is to promote condom use.
But what happens when you can't get the people most at risk to abstain? What happens when the human sex drive proves infinitely stronger than a briefcase full of admonitions?
Note the underlying racism and cultural prejudice that implies that those people (i.e., Sub-Saharan Africans) can’t control their animal instincts to rut. Since they can’t abstain or remain faithful to their partner, we must ensure that they at least use a condom. Dolman, and others like him who claim that changing sexual behavior can’t work, would probably be offended if it was implied that they couldn’t control their own hormonal impulses. Yet when the same claim is made about Africans, everyone nods in agreement as if they were stating a an obvious fact of nature.
But as with most impressions based on stereotypes, the facts have a way of getting in the way. As the USAID report on the ABC study found:
It appears that Uganda’s decline in HIV prevalence was associated with positive changes in all three ABC behaviors: increased abstinence, including deferral and considerably reduced levels of sexual activity by youth since the late 1980s; increased faithfulness and partner reduction behaviors; and increased condom use by casual partners. The most significant of these appear to be faithfulness or partner reduction behaviors by Ugandan men and women, whose reported casual sex encounters declined by well over 50 percent between 1989 and 1995. This conclusion is supported by comparisons with other African countries. [emphasis added]
That last sentence is the key to understanding just how important that “A” and “B” portions of the ABC program are for reducing HIV. During the 1990s the condom use in Uganda, Zambia, Cameroon, Kenya and Zimbabwe all increased significantly. But out of the five, only Uganda and Zambia saw a corresponding decrease in HIV prevalence. What was different about those two countries? They also had significant delays in the onset of sexual activity, declines in premarital sex, and large declines in extramarital sex and multiple sexual partnerships. The other three countries did not.
The fact remains, as the USAID admits, that there would not be a global AIDS pandemic if people did not have multiple sexual partners. Monogamy is not only the most effective “vaccine” against HIV infection, it could, if broadly implemented, wipe out the disease within a generation. The Ugandans are a prime example of how effective such a strategy can be. The country was able to reduce its HIV prevalence from 30% to 6% due largely to their adoption of what they call “zero grazing” – being faithful in marriage or partner reduction outside of marriage.
Every country, including the U.S., that has seen a reduction in HIV prevalence, has also had a reduction in the sexual partners of the high risk groups. Condoms may help slow the spread of the disease. But only changes in sexual behavior – particularly partner reduction and abstinence – will stop HIV.
As President Musevnai noted, “Aids is mainly a moral, social and economic problem. I look at condoms as an improvisation, not a solution." He went on to add that condoms represented "institutionalized mistrust" and called instead for "optimal relationships based on love and trust." We should show that same “love and trust” to our neighbors in Africa by sharing with them the simple truth: condoms won’t save you if you’re grazing beyond your own pasture.
Update: After I finished this post I realized that I failed to make it clear where the lines of dispute are drawn in this controversy. The issue isn’t between “abstinence-only” and the “ABC approach” but between “ABC” (Abstinence, Be Faithful, Condoms) and CNN - Condoms, Needles, Negotiating Skills. The CNN advocates don't like the idea of promoting abstinence at all.
Related: Joshua Davey makes some excellent points here and here:
I find [Congresswoman Barbara Lee's] contention that expecting people to live in accordance with the sexual mores that have been universally shared (or very nearly so) by all human cultures in all times and places quite remarkable. And I must confess that I am baffled by her assertion that “abstaining from sex is oftentimes not a choice.” Does she mean that a significant number of new AIDS infections are caused by rape? But that would not make sense in this context, because the rape victim obviously cannot choose to use a condom, and I doubt that many rapists will either.
Science is based on theories, predictions of the future, and measuring results.
The "promote condom use" theory predicts greatly reduced HIV infections. So far, theory has mostly failed to achieve results.
The "promote faithfulness use" theory predicts greatly reduced HIV infections. So far, this theory has been shown, scientifically, to have the best results.
The problem is one of "perfection". The condom theorizers assume, dishonestly, perfect use -- yet blame the poor results on the inevitable imperfect use, claiming bad education, not enough support, blah blah blah.
Those same pro-condom folk assume imperfection in faithfulness, and therefore deny its usefulness as a norm.
Perhaps you guys missed what the Ugandan program is called, ABC. It stands for the three steps to HIV prevention: Abstinence, Being faithful and Condoms. Does that sound like the abstinence only approach that Bush and the religious right are pushing? You hold up thed Uganda thing as a model. I agree that it is. The model is to push for reduced numbers of partners but also provide condom education since even with reduced numbers people are still having sex with multiple partners. Why our politicians on both sides insist on doing one or the other and not both, as in the case of Uganda, is beyond me. Why Bush and the religious right insist on only giving funding to abstinence only programs is also beyond me. Under that model Uganda would be ineligible--don't forget the "C" in "ABC".
Joe,
Ironically the USAID report you quoted said the biggest contributor was "B" (Be Faithful) not "A" (abstinence). Hell the title was "The Missing 'B'." So again, the conclusion is that the best thing to do is minimize sexual partners and use condoms rather than expect that the majority of the population will remain abstinent until finding one special partner. Although the abstinence approach is ideal, it is just as blind as saying that condom use is 100% effective. There is no such thing.
Mr. Moderate,
Ironically the USAID report you quoted said the biggest contributor was "B" (Be Faithful) not "A" (abstinence). Hell the title was "The Missing 'B'."
Um, why is that ironic? The title of the post was “zero grazing” which I pointed out was defined as “being faithful in marriage or partner reduction outside of marriage.”
So again, the conclusion is that the best thing to do is minimize sexual partners and use condoms rather than expect that the majority of the population will remain abstinent until finding one special partner.
Let me point out again what the data shows:
1) Promotion of condoms alone is not effective.
2) Once people become sexually active, partner reduction and monogamy is the most effective approach.
3) Abstinence until entering a monogamous relationship reduces the overall HIV prevalence.
Although the abstinence approach is ideal, it is just as blind as saying that condom use is 100% effective. There is no such thing.
Bush’s push for “abstinence-only” is limited to American education programs. I personally see nothing wrong in telling children that the best way to prevent getting HIV is by not having sex.
As for the global effort, Bush has adopted the ABC approach. The dispute isn’t over “abstinence-only” versus “ABC” but “ABC” versus “CNN” -- Condoms, Needles, Negotiating Skills.
Bush’s push for “abstinence-only” is limited to American education programs. I personally see nothing wrong in telling children that the best way to prevent getting HIV is by not having sex.
So it's okay for everyone else to use ABC but we should stick with just "A"? That's the idea. I already said that the all or nothing approach with "A" or "C" is ludicrous.
Your link to Bush adopting the "ABC" model is humorous. I see a whole bullet point for "abstinence" programs but none for funding condom distribution. Buried in a "first year plan" is a slight referenc to "ABC" but that is part of some big push for health care providers. I was going to give him credit for addressing the condom issue until I read this NewsMax story. It starts off saying that Bush is conceding that condoms need to play a roll, but then goes on to say this:
Still, Bush said, the Uganda approach was working and was a "practical, balanced and moral message." And he added the abstinence-only method was the most effective.
Was that the conclusion of the report? The ABC model is an abstinence-only method? Again what happened to "B" and "C." "ABC" is not abstinence only HIV prevention. It is common sense HIV prevention.
Mr. Moderate,
So it's okay for everyone else to use ABC but we should stick with just "A"? That's the idea. I already said that the all or nothing approach with "A" or "C" is ludicrous.
Why is it ludicrous to encourage children --- who shouldn’t be having sex anyway – to remain abstinent?
Your link to Bush adopting the "ABC" model is humorous. I see a whole bullet point for "abstinence" programs but none for funding condom distribution.
Funding condoms for...who? Do you need the government to ensure that you receive condoms because you can’t control your sexual urges? ; )
Buried in a "first year plan" is a slight referenc to "ABC" but that is part of some big push for health care providers.
I’m not sure what you are referring to when you say “buried.” Here is the reference:
I was going to give him credit for addressing the condom issue until I read this NewsMax story. It starts off saying that Bush is conceding that condoms need to play a roll, but then goes
on to say this:
Still, Bush said, the Uganda approach was working and was a "practical,
balanced and moral message." And he added the abstinence-only method was the
most effective.
Actually, you probably should have used what Bush actually said rather than the journalist summary. Bush said:
Was that the conclusion of the report? The ABC model is an abstinence-only method? Again what happened to "B" and "C." "ABC" is not abstinence only HIV prevention. It is common sense HIV prevention.
We are talking about apples and oranges. The A-O is for school education. The ABC is for global education. It should be noted, however, that in the ABC program, school-age children are encouraged to follow the path of abstinence.
I'll start taking the "use condoms" argument seriously when I get a straight, logical answer to the following question:
If people can't be trusted to be disciplined enough to keep from having sex, how is it they can be trusted to engage in "safe" sex? That whole "faithful in little is faithful in much" thing...
Why is it ludicrous to encourage children --- who shouldn’t be having sex anyway – to remain abstinent?
Children aged 8-13 or so, I'd agree. After that they will start experimenting. Encouraging abstinence but still providing them with information on condoms sounds like a sound policy to me. And it's part of the ABC program.
Funding condoms for...who? Do you need the government to ensure that you receive condoms because you can’t control your sexual urges? ; )
I'm fine paying for my own condoms. Having public health clinics provide condoms is where the funding I'm speaking of comes in. Once again it is one of the parts of the ABC plan.
I’m not sure what you are referring to when you say “buried.” Here is the reference:
Yeah I read it. Four words out of 71 and one point out of a long list. That sounds like top billing to me.
The A-O is for school education. The ABC is for global education. It should be noted, however, that in the ABC program, school-age children are encouraged to follow the path of abstinence.
Abstinence encouraged again is not abstinence only. So once again we are advocating the ABC program abroad but not at home.
I'm all for common sense sex education and HIV prevention. It's a shame neither the religious right nor the reproductive rights crowd are. The religious right want to pretend we're all going to have just one partner our entire lives. The reproductive rights crowd think people will use condoms 100% of the time and can have daily random sexual flings. As usual, the right approach is in the middle ground. That's all I'm advocating. Both sides need to step back and take a look at what they are saying.
Even if Bush were to do abstinence only, it seems there is a misperception that doing so will ban all condoms in the country or something, whereas in fact there will not be one less condom because of it.
The evidence shows that condom use is of little relevance to HIV transmission, because increases in condom use have a very low - possibly lower than zero - correlation to HIV transmission rate. If HIV infection rate increases in some countries with increased condom use, but decreases in other countries with increased condom use, the correlation between condom use and infection rate falls toward -1 in an amount depending on the population size of each sample (country).
If condom use does not correllate or only negatively correllates with hiv infection rate, then out of the ABC formula only A&B are effective (condom use has a random effect), although we don't know if it's either of them or both. Causation is not a problem, as Joe pointed out, when you know that IF A&B THEN NOT STD.
Children aged 8-13 or so, I'd agree. After that they will start experimenting.
Why do they begin experimenting? Because they are told the lie that there is such a thing as "Safe Sex" outside of a monogomous relationship. They are taught that the act of sex is something they have no power to prevent, and so they shouldn't bother to try to control their behavior (except to ensure that a piece of latex is used when they can't control their behavior.)
The religious right want to pretend we're all going to have just one partner our entire lives.
No, the religous right acknowledges that we are all sinners, and that that individual acts of sin do carry consequences. Hence, premarital/extramarital sex does increase the likelhood for exposure to AIDS.
Children aged 8-13 or so, I'd agree. After that they will start experimenting.
Why do they begin experimenting? Because they are told the lie that there is such a thing as "Safe Sex" outside of a monogomous relationship. They are taught that the act of sex is something they have no power to prevent, and so they shouldn't bother to try to control their behavior (except to ensure that a piece of latex is used when they can't control their behavior.)
The religious right want to pretend we're all going to have just one partner our entire lives.
No, the religous right acknowledges that we are all sinners, and that that individual acts of sin do carry consequences. Hence, premarital/extramarital sex does increase the likelhood for exposure to AIDS.
Children aged 8-13 or so, I'd agree. After that they will start experimenting.
Why do they begin experimenting? Because they are told the lie that there is such a thing as "Safe Sex" outside of a monogomous relationship. They are taught that the act of sex is something they have no power to prevent, and so they shouldn't bother to try to control their behavior (except to ensure that a piece of latex is used when they can't control their behavior.)
The religious right want to pretend we're all going to have just one partner our entire lives.
No, the religous right acknowledges that we are all sinners, and that that individual acts of sin do carry consequences. Hence, premarital/extramarital sex does increase the likelhood for exposure to AIDS.
I feel sorry for people who get so angry and argumentative about something they are quite ignorant about. For starters, the "abstinence only" program was signed into law by President Clinton. All Bush does is throw more money at it in the budgets he signs. If you don't like the PROGRAM, your anger should be directed at Clinton for making it the law of the land. Only Bush hatred would find fault in a Republican spending even MORE money on a program introduced to this country by a Democrat.
But of course, abstinence only does not mean a school can ONLY TEACH ABSTINENCE. I thought this was obvious and well known, but apparently Mr. Moderate and others are unaware. The state of New York for example pockets over 7 million in these funds and still teaches about condoms.
Each state is quite independent as to what it chooses to teach its kids. Nobody can blame President Bush (or Clinton) for what a state chooses to teach or not to teach.
The "only" refers to the fact that abstinence must be taught as the ONLY 100% foolproof method to avoid STDs, unwanted pregnancies, and other associated health problems. (Point 3 of the 8-point plank)
Here is a link to educate yourself on each state.
http://www.siecus.org/policy/states/AGI_Chart.pdf
'I personally see nothing wrong in telling children that the best way to prevent getting HIV is by not having sex.'
ok fine. but what happens when they get older and they aren't aware of the options?
'No, the religous right acknowledges that we are all sinners, and that that individual acts of sin do carry consequences. Hence, premarital/extramarital sex does increase the likelhood for exposure to AIDS.'
the fire and brimestone stuff doesn't work on kids. i am for promoting abstinence for young teeens, but as ythey get older it just doesn't work. if you tell them not to do somesomething becasue it is sina nd they will go to hell then they will want to do it more.
i am not saying we should just pass out condoms, i think stressing the emetional impact that multiple partners in a sort period of time can have is a more productive path.
Why do they begin experimenting? Because they are told the lie that there is such a thing as "Safe Sex" outside of a monogomous relationship.
The last I checked, teenage pre-marital sex was quite common in throughout history. It isn't something that was spawned during the sexual revolution. Nice try though.
tommythecat -
Who said anything about Fire and Brimstone? And why would I tell someone they are going to hell for having sex? I was talking about consequences in THIS life for our WRONG choices. Choosing to have premarital and /or extra-marital sex exposes you to the possibility of acquiring life-threatening disease.
Engaging in sexual activity is a MORAL choice... Teaching kids to live their lives within a moral framework DOES work.
You don't go to hell for individual acts of sin... You go to hell because of the nature of sin that is within you. You don't go to heaven by being good. You go to heaven by having God change your nature through the blood of Jesus. I'd be glad to explain off-thread if you're interested.
For starters, the "abstinence only" program was signed into law by President Clinton.
Yes. The religious right successfully added this to the welfare reform bill that Clinton wanted passed. It was added by the religious right during the revision phase usually reserved for technical revisions. It was therefore Clinton's choice to veto his entire welfare reform law or let the sneakily added provision become law. Blame the religious right, not Clinton for that one. This information can be founded at SEICUS, you linked to them previously at this link:
http://www.siecus.org/policy/SReport/srep0001.html
It was therefore Clinton's choice to veto his entire welfare reform law...
Like he did two time before? He didn't want welfare reform, the people did. You know, contract with America and all that stuff?
By the way, it was Bill Clinton that shut down the government, not Newt. You're looking less moderate and more leftist with each post.
By the way, it was Bill Clinton that shut down the government, not Newt. You're looking less moderate and more leftist with each post.
Oh that's right. The Democrats had nothing to do with it. Only those self-righteous republicans would come up with something like that. Pardon me for not being a party ideologue like you. I guess that's what makes me moderate and not "right wing."
"Bipartisanship is another name for date rape," Norquist, a onetime adviser to former House Speaker Newt Gingrich, said, citing an axiom of House conservatives.
Is that the element of the Republican party you want running the show? Unfortunately it is.
Mr. Moderate, you are a classic.
Clinton managed to find the willpower to veto a lot of bills passed by "the religious right", and he even was a tremendous politician in using the government shutdown to hurt Republicans.
If you on the left are amazed at our "obsession" with Clinton...many of us continue to be amazed at how you on the left continue to blame everything he signed (DOMA, tax cuts and this) to the evil religious right, holding poor Bill hostage. What a laughable joke.
He vetoed welfare reform TWO TIMES before signing it. Why? You can decide if he sold out his country for his own electable skin, or you can decide if he agreed with the program, but you sure can't take the path you are trying to go on and look credible at all.
I used that link because of its state by state analysis..not because of the political spin they take on the issue. But as it says, this issue was hardly a new one in 1996, going all the way back in some form to 1981.
And the Senate vote was 75 to 24 in FAVOR. Kerry voted Yes. Edwards was still not elected in 1996.
But blame the religious right all you want. It is about as genuine as your post nickname.
"Bipartisanship is another name for date rape,"
Sounds reasonable to me, given the proper context.
Being a leftist is not moderate. I AM moderate. And tolerant.
Abstinence still works everytime it's used. (Unlike condoms.)
gaw & steve,
You guys are really obtuse. The legislative process unforutanely allows for the pushing of rider bills into these large omnibus legislation packages. They do this because they know that the entire bill won't be sacrificed for all but the most aggregious of these sly additional pieces of legislation. Clinton vetoed it twice and got a third package that most people can agree on and then the religious right, what would you call the senators who added this to a bill that it had no business being in, forced this into it knowing he wouldn't derail it over that issue.
Of course you are a moderate gaw, just like all those other good moderates--DeLay, Falwell and Santorum. It's amazing how much you moderates look a lot more like the far right.
I'd rather be obtuse than be leftist... Yeah, and Delay and Santorium are fairly moderate too.
I prefer the descriptive term "having firm convictions based on biblical values" to the perjorative "right wing." Seeing as how this is where I believe the political center of America is, I consider that to be moderate.
They do this because they know that the entire bill won't be sacrificed for all but the most aggregious of these sly additional pieces of legislation