Stanford HIV study casts doubt on abstinence efforts in Africa


#1

sfgate.com/health/article/Stanford-HIV-study-casts-doubt-on-abstinence-7388494.php


#2

Of course it does. :slight_smile:


#3

“AIDS and the churches: getting the story right.” First Things. firstthings.com/article/2008/04/002-aids-and-the-churches-getting-the-story-right

excerpts:

Responses to the global HIV/AIDS epidemic are often driven not by evidence but by ideology, stereotypes, and false assumptions. Referring to the hyperepidemics of Africa, an article in The Lancet this fall named “ten myths” that impede prevention efforts”including “Poverty and discrimination are the problem,” “Condoms are the answer,” and “Sexual behavior will not change.” Yet such myths are held as self-evident truths by many in the AIDS establishment. And they result in efforts that are at best ineffective and at worst harmful, while the AIDS epidemic continues to spread and exact a devastating toll in human lives.

Consider this fact: In every African country in which HIV infections have declined, this decline has been associated with a decrease in the proportion of men and women reporting more than one sex partner over the course of a year”which is exactly what fidelity programs promote. The same association with HIV decline cannot be said for condom use, coverage of HIV testing, treatment for curable sexually transmitted infections, provision of antiretroviral drugs, or any other intervention or behavior. The other behavior that has often been associated with a decline in HIV prevalence is a decrease in premarital sex among young people.

If AIDS prevention is to be based on evidence rather than ideology or bias, then fidelity and abstinence programs need to be at the center of programs for general populations. Outside Uganda, we have few good models of how to promote fidelity, since attempts to advocate deep changes in behavior have been almost entirely absent from programs supported by the major Western donors and by AIDS celebrities. Yet Christian churches”indeed, most faith communities”have a comparative advantage in promoting the needed types of behavior change, since these behaviors conform to their moral, ethical, and scriptural teachings. What the churches are inclined to do anyway turns out to be what works best in AIDS prevention.

This good news is often lost on organizations that purport to represent churches and the faith-based response to AIDS. The Berkley Center at Georgetown University, for instance, issued a report late last year called Faith Communities Engage the HIV/AIDS Crisis . The report is worth taking seriously, as it reflects the thinking of many international organizations, including many of the faith-based organizations that respond to AIDS. This thinking is often drastically out of sync with the culture and values of the beneficiaries. The Georgetown report claims to explore “development issues from the perspective of faith institutions,” but in fact the report betrays a deep ambivalence about whether faith communities, particularly Christian churches, are part of the problem or part of the solution to AIDS.

Katherine Marshall and Lucy Keough, lead authors of the report, are clearly uncomfortable with approaches to HIV prevention that emphasize sexual responsibility, behavior change, and morally based messages. They praise the work and compassion of faith communities in treating and caring for people *living with AIDS and their families, yet harshly *criticize the messages of faith communities for increasing the stigma of AIDS. Their discomfort with attempts to change sexual behavior is evident early in the report, when, for example, they muse: “Should the focus be on changing the behaviors that contribute to HIV/AIDS? (Is that possible? Desirable ? How? With what assurance?)”

If Marshall and Keough are undecided as to whether changing sexual behavior is even desirable in the context of an epidemic driven by people who have more than one sex partner, they then need to become educated in the basic epidemiology of HIV transmission. One must ask whether they are more concerned with upholding a Western notion of sexual freedom or with saving lives. Their concern over any prevention approach that might be “moralistic” causes them to miss entirely the evidence for the remarkable success of sexual-behavior change in reducing HIV infections. They miss, as well, the crucial contribution of faith communities to HIV prevention, even while they are producing a report on the role of faith communities in the HIV crisis.


#4

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