CULTURE & COSMOS

January 13, 2004 Volume 1, Number 23

New Research Shows Dangers of Condoms in HIV Prevention

        Availability of condoms statistically increase promiscuity and risk of contracting HIV according to medical experts who presented their findings on the "ABC" approach to the HIV/Pandemic in Washington, DC last week. The presentations, hosted by the Medical Institute for Sexual Health, were critical of the insistence by some NGO's and policy makers that the "C" (condom) approach will stem the tide of the pandemic.

        "20 years into the pandemic there is no evidence that more condoms leads to less AIDS," stated Dr. Edward C. Green of Harvard's' Center for Population and Development Studies. Citing data on condom availability in many African counties, Green went on to say that "we are not seeing what we expected: that higher levels of condom availability result in lower HIV prevalence." Dr. Norman Hearst of the University of California --- San Francisco supported this analysis with statistics on Kenya, Botswana, and other countries, which show an increasingly alarming pattern of increased condom sale correlation with rising HIV prevalence by year.

        Promotion of the "safe-sex" message has reportedly increased numbers of sexual partners. The spread of HIV is a behavioral problem, according to Green, who said that "having multiple sexual partners drives AIDS epidemics. If people did not have multiple sex partners, epidemics would not develop or, once developed, be sustained." He continued, "over a lifetime, it is the number of sexual partners [that matter]...condom levels are found to be non-determining of HIV infection levels."

        Unfortunately, Hearst stated, we are "raising a generation of young people in Africa that believe that condoms will prevent HIV." This is concerning because condoms are not 100% effective, even when used properly. According to Hearst, "the most recent Met-analysis came up with 80%...but even if it is 90%, over time it's the question of when, not if...you don't want to give people a false sense of security and A and B are better in the long term."

        In other cases, often reported by proponents of the safe-sex message, countries such as Thailand saw incidence rates for HIV decrease after the government mandated 100% condom use in brothels. Unfortunately, according to Hearst and Stoneburner, proponents rarely look closer at the data, and in such instances behavior change had much more to do with the decreased rates of transmission. "This is usually attributed to 100% condom use, but visits to sex workers declined by 60%...they did so out of fear and risk avoidance."

        It is the behavior change advocated by the "A" and "B" approach that is additionally supported by data, such as in the famed Uganda case. According to Dr. Rand Stoneburner (formerly of the WHO and an independent advisor to USAID), "declines of HIV in Uganda are linked to behavior change...[and] include primary risk avoidance with a 65% decline in causal sex." The Ugandan government, which promoted abstinence and faithfulness, helped bring about a 75% decline in HIV prevalence among 15-19 age group, 60% in the 20-24, and a 54% decline overall by 1998.

        Stoneburner and others believe the change was due to different language used. In Uganda, President Museveni reportedly repeated to Ugandans "you are going to die if you don't stop this!" whereas in other countries, there is little talk of death. Stoneburner pointed out "25% of South Africans don't believe HIV causes AIDS" and in many countries "they do not talk about death links to AIDS." This information proves the unfortunate effectiveness of the "safe sex" message that increasingly places individuals at risk for HIV transmission and STDS worldwide.