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I Don't Get It

Is there really a debate as to whether abstinence + being faithful + condoms (ABC) vs. condoms only in AIDS protection? How can anyone seriously argue that advocating a combination of abstinence, committed monogamous relationships, and condom use is a worse approach than condom only education. There is only one 100% effective way to avoid sexually transmitted diseases, and that's abstinence. People who are sexually active are best protected by monogamous relationships and condom use.

To advocate condom-only education programs is highly irresponsible because, regardless of the faith in them placed by Lee and her ilk, they not 100% effective. In fact they provide only an 85% decrease in the risk of heterosexual (penis to vagina) AIDS transmission. To attempt to steer policy away from additional techniques that work (in conjunction with condom use) because you are "anti-religion" is the worst kind of hypocrisy.

Abstinence and committed monogamous relationships have served humans well for thousands of years. Are they perfect or infallible? Of course not, but just as AIDS is now treated with a cocktail of drugs that each address part of the immune deficiency; a multi-faceted approach to the AIDS epidemic is far more effective than the one size fits all approach advocated by Lee.

I guess it comes down to this - personal responsibility (ABC) vs. technological responsibility (putting your faith in the condom).


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Comments (5)

In the article linked to ab... (Below threshold)
Mike:

In the article linked to above about the controversy, US Congresswoman Barbara Lee (the lone dissenter in the vote waging was against terrorism) states the following:

"In an age where five million people are newly infected each year and women and girls too often do not have the choice to abstain, an abstinence until marriage program is not only irresponsible, it's really inhumane," Lee said.

"Abstaining from sex is oftentimes not a choice, and therefore their only hope in preventing HIV infection is the use of condoms," she added.

I'm curious, what point she is trying to make with these 2 statements. Because what makes her think that if the girls don't have a choice whether or not to have sex that they have a choice whether or not the guy uses condoms? It would seem to me that she is just posturing against the Bush administration instead of thinking clearly. Even if the girls are prostitues, if they are forced into the trade, it's not like they then have the authority to demand the use of condoms.

Abstinence = inhumane, now there's someone with a firm grasp of reality.

There's the issue of limite... (Below threshold)

There's the issue of limited resources, and how to allocate them. It's a matter or working within constraints of time, budget, staff, etc.

BTW: "There is only one 100% effective way to avoid sexually transmitted diseases, and that's abstinence." overstates the case; there's still rape, for example.

For most of the last three ... (Below threshold)
Jack:

For most of the last three years, the debate has been framed slightly differently. Social conservatives within the Bush Administration have worked fairly actively to prevent the promotion of condom useage on the ground that such promotion undermined the teaching of abstinance. The opposition of AIDS activists derives from their view that widespread availability of and education about condoms is an essential component of AIDS prevention, even if abstinance is another useful option.

The other issue here is the tension between solutions for individuals and solutions for the public health. There are many health measures that are good for individuals, but which fail or are simply insufficient from a public health perspective because of poor compliance. For example, a voluntary vaccination program will protect individuals from infection, but it may not protect the public health because of inadequate compliance. Well, abstinance may work well for individuals who adhere to it, but the burdens of abstaining, as it were, may be such that compliance, and therefore the public health, suffers. You need both. AIDS activists generally realize that monogamy is better than promiscuity, and that condom use is better than otherwise. The advocates of abstinance, however, have generally opposed condom programs, which opposition undermines the public health.

All nice and reasonable, Ja... (Below threshold)

All nice and reasonable, Jack, but you have it exactly backwards.
The Bush Administration is not proposing abstinence only, nor are they blocking condom use. As a point of verifiable fact, it is the Bush Administration pushing for Abstinence + Being Faithful + Condoms. It is the liberal Democrat pushing for a single method of protection: condom only. Also as a matter of verifiable fact, the AIDS activists don't realize anything reasonable you are trying to give them credit for: they are upset that Uganda doesn't drop its successful ABC program and turn to a Thailand condom-only program that was marginally successful among an extremely limited population more than a decade ago (and hasn't been as successful since).

So AIDS activists, liberals, and Democrat politicians are actively advocating a method proven to be ineffective 15% of the time even when used properly, to the exclusion of a method 100% successful when used properly (yeah, it doesn't work so well in rape, but nothing does: it's criminal sexual assault). What possible reason could they have for actively blocking a successful program?!?!??

The problem with this argum... (Below threshold)
Jack:

The problem with this argument is that both sides are being disingenuous. Sure, the Bush Administration has done a lot for AIDS prevention, and will do more. Yes, it has increased the availability of condoms. However, it has done this under some extraordinary regulation of the content of public health materials developed with government funds. The Centers for Disease Control have recently published a new set of regulations that narrowly limit the types of educational materials that may be used, lest some prude's sensitivities be offended -- you will not even be able to demonstrate the correct application of a condom on a dildo or a cucumber without running afoul of these rules. More troubling, the proposed regs require disclosure about the extent of the lack of effectiveness of condoms in the prevention of STDs. These requirements, which will result in statements of risk that cannot possibly be evaluated sensibly by the typical African at risk for AIDS (or even the typical American teenager), are obviously designed to discourage condom use, rather than promote it.

Now you might say, hey, what's wrong with disclosing the relative effectiveness of a medical device? Nothing per se, but condoms are unpleasant to use, and people are very concerned that if federally-funded educational programs emphasize their failure rate eager males will, at the margin, use that as a rationale not to use condoms. The worst result would be a program that undermines the credibility of condoms so that when abstinance education fails, as it will in most cases, people forego the secondary protection of condoms to access the ephemeral pleasure of unprotected sex.

In any case, effective public health often requires, or is thought to require, some measure of deception to further the greater good. For example, to this day most gynecologists do not tell women that cervical cancer is essentially an STD. Why? Because they are concerned that if women believe that a Pap smear is a test for an STD, some percentage of them will forego having the test out of modesty. This is paternalistic for sure, but to some degree all public health is paternalistic. Otherwise, we would let people sterilize their own drinking water rather than render it potable as a public service.




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