|HIV/AIDS in Africa: What is the Science actually saying? by Deirdre Fleming|
“Blind faith trumping common sense,” “?>Vatican insiders declare the Pope a disaster,” “Outrageous,” “Irresponsible” …If anything is embarrassing, it is the sensationalism of such statements in the Western media when giving the party line of anti-Catholic sentiment. The trouble is that when one looks at the science of AIDS research today, one finds a completely different story from the one being promoted by the popular media.
The problem for
the layman is that certain organizations which sound
authoritative make claims
regarded as “expert
suggested that his
On the other hand, authorities in the field who disagree with these sorts of statements get scant media attention. Here I am not talking about renegade scientists, but professionals in HIV/AIDS research who provide technical reports to the World Health Organisation (WHO) and The Joint United Nations Programme on HIV/AIDS (UNAIDS).
Take, for example, Edward Green, director of Harvard University’s Aids Prevention Research Project (APRP): in an interview with CNA, Green stated with reference to Africa, “Theoretically, condoms ought to work, and theoretically, some condom use ought to be better than no condom use, but that’s theoretically … We just cannot find an association between more condom use and lower HIV reduction rates.”
This view is
echoed by Helen Epstein, specialist in public health in
developing countries and
to Human Rights
2008 letter to UNAIDS she bemoans the disconnect between
on-the-ground research about condoms and UN reports:
decline in HIV
infections in US
modeling studies by Martina Morris and
surveys carried out
AIDS prevention when
towards such areas as the
The trouble with condoms is that they have the effect of giving users a false sense of security which results in disinhibition, that is, users indulge in greater risk taking which eventually negates any protective effects of the condom. According to Potts et al., “When most transmission occurs within more regular and, typically, concurrent partnerships, consistent condom use is exceedingly difficult to maintain.”  James Shelton of the Bureau for Global Health, USAID, in Washington DC puts it this way: “Many people dislike using them (especially in regular relationships), protection is imperfect, use is often irregular, and condoms seem to foster disinhibition, in which people engage in risky sex either with condoms or with the intention of using condoms.” “Condom use with prostitutes and in one-night stands is increasingly the norm all over the world, but they are rarely used in longer-term, less businesslike affairs,” observes Helen Epstein.
It is becoming
increasingly clear to AIDS researchers that some of the
prevention strategies are
unsupported by the
created by a
failure to differentiate
ABOUT GENERALISED HIV
from Shelton J,
Ten myths and one
truth about generalized HIV epidemics, (2007)
The Lancet, Vol 370,
p.1809.9 Myth Truth Of more importance are simultaneous (concurrent) long-term
relationships, both formal, as in polygamy, and
informal. Although men’s behaviour is important, women having multiple
partners are a significant
contributor. Epidemics span all reproductive ages. HIV incidence increases in women
in their twenties and
older. The world’s highest HIV prevalence occurs in countries with greater
such as Rwanda,
Congo, known for
and rape have been much
affected. There is no consistent relationship between condom use and the
decline of a generalized
epidemic. Evidence is mounting that behaviour change is possible and has
already happened in some areas.
Treatment seems to lead to disinhibition rather than stopping new
infections. New technology is expensive and engenders a false sense of
MYTHS ABOUT GENERALISED HIV EPIDEMICS?>
adapted from Shelton J, Ten myths and one truth about generalized HIV epidemics, (2007) The Lancet, Vol 370, p.1809.9
Of more importance are simultaneous (concurrent) long-term relationships, both formal, as in polygamy, and informal.
Although men’s behaviour is important, women having multiple partners are a significant contributor.
Epidemics span all reproductive ages. HIV incidence increases in women in their twenties and older.
The world’s highest HIV prevalence occurs in countries with greater wealth and literacy, such as Botswana (25%) and Swaziland, while countries such as Rwanda, Angola and Congo, known for episodes of conflict, genocide and rape have been much less affected.
There is no consistent relationship between condom use and the decline of a generalized epidemic.
Evidence is mounting that behaviour change is possible and has already happened in some areas.
Treatment seems to lead to disinhibition rather than stopping new infections.
New technology is expensive and engenders a false sense of security.
James Shelton there are a number of myths that impede
David Wilson of World Bank and Daniel Halperin of the Harvard School of Public Health agree. “For too long, the global HIV-prevention community has pursued generalized responses in concentrated epidemics, concentrated approaches in generalized epidemics, or hedged their bets and done a bit of everything,” they said in the Lancet, August 2008.
“For example, after three decades, the
global community is only beginning to accept that there is
inequality, and HIV.
countries have the
highest, not the
In 1993, Helen Epstein was
working as a molecular biologist in
An article by
Potts et al. in Science explains it
as follows: “In
Potts and his team plead for a reassessment of funding for interventions that have the greatest potential impact. In a letter responding to comments by the Department of Evidence, Monitoring and Policy at UNAIDS, they say, “We note that the requested funding for [hyper-endemic and generalized] epidemics would comprise only a little over 20% of the global total, even though such epidemics account for over two-thirds of all HIV infections worldwide. Also, although 5% of this funding would be dedicated to circumcision programs, the large majority of resources would continue to be allocated to other interventions, for which the evidence of prevention impact in generalized epidemics is much weaker … Recent CDC data from Uganda suggest that most married people who recently acquired HIV were infected by an extramarital partner or by their spouse who had recently acquired HIV from an extramarital partner. Many of the latter were probably in the brief “acute infection” period, when HIV infectivity is much higher yet undetectable by a standard HIV test. It is crucial to address the multiple and concurrent partnerships that mainly drive these generalized epidemics.” 
A growing number
questioning why the
approach has not
Claiming that AIDS has been spread because of the lack of human rights for “vulnerable populations”, such as homosexual men and sex workers, the UN, in the document International Guidelines on HIVAIDS and Human Rights, have suggested that AIDS cannot be defeated unless all international laws restricting human sexuality are amended: “Criminal law prohibiting sexual acts (including adultery, sodomy, fornication and commercial sexual encounters) between consenting adults in private should be reviewed, with the aim of repeal.” The Guidelines also promote abortion on demand, legalization of homosexual marriage, and laws “providing penalties for vilification of people who engage in same-sex relationships.” One could argue that to the UN, AIDS funding is more about promoting the ideologies of the sexual revolution than about using the research to promote public health.
“To treat one
AIDS patient with life-prolonging anti-retroviral drugs
costs more than $1,000 a
successful ABC campaign
cost just 29
cents per person each
"Maybe they tried [abstinence] and it failed, and since it failed with them, they think it will fail with everyone. I'm a testimony myself. I finished my primary [school] without having sex. I went for my secondary education, I didn't have sex, I went to University, I was not having sex. I never fell sick because of not having sex. Can this world tell me that it only worked with me? The way it worked with me it can work with everyone else. My friends who used to laugh at me thinking that abstinence is abnormal, most of them are dead by now.”
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