Today’s NRO editorial praises Bush’s new funding for treatment and prevention of HIV/AIDS in Africa, and reports the successes of ABC (Abstinence, be Faithful, always use a Condom) programs the Bush administration favors.
But for PhiBetaCons’ purposes, it also takes on one of the dogmas fostered by the academy (with the exception of Prof. Ted Green of Harvard’s School of Public Health, quoted herein), that condoms are the “end-all, be-all of AIDS prevention”:
[T]he public-health lobby remains unthinkingly devoted to dated assumptions forged in the fight against AIDS in the developed world. There, homosexual men and intravenous drug users are disproportionately afflicted by AIDS, and together compose a majority of its sufferers. In such a context, distributing condoms and clean needles to particularly high-risk groups makes sense.
But the African AIDS problem is fundamentally different. There, the disease is a generalized epidemic, and is spread much more evenly throughout society than in the West. This difference has implications for how HIV can be prevented. The ABC approach favored by the Bush administration is incorporative — it reinforces existing norms of abstinence for young Africans and monogamy for their elders, and presents condoms as a less surefire preventative technique for those who are already sexually active. This is a far cry from the mischaracterization of the policy as an “ineffective ‘abstinence only until marriage’ education,” as one indignant press release last Wednesday called it.
Really, it is the public-health lobby that has nurtured a dogma — condom promotion to the exclusion of other techniques — and has thus been blinkered to local conditions. As Edward C. Green of Harvard’s School of Public Health points out, “More condoms have not translated into lower infection rates. People who use condoms take more risks, and they use them inconsistently. Even if they are used consistently, the risk is only reduced by 80 to 85 percent.” The time has come for the public-health lobby to disabuse itself of the notion that condoms are the end-all, be-all of AIDS prevention.