Why we’re losing the war against HIV/AIDS

Harvard public health scientist Edward C. Green is interviewed by Christianity Today about his claim that successful ABC Programs (abstinence, be faithful, condoms) are being undermined by the drugs and condoms approach popular with AIDS activists in the US. Green believes this shift away from behavior modification will undo the gains that have been achieved in Africa and elsewhere.

The spinmeisters make two claims… One, since condoms went up and prevalence continued to go down, condoms made prevalence go down. We know that’s not true because condoms went up in every country in Africa and in several countries condom user levels went higher than Uganda and infection rates didn’t come down, they went up. …

I said it in my 2003 book that the single most important behavioral change was fidelity, and most of that is marital fidelity. It wasn’t actually abstinence. Most Ugandans are between the ages of 15 and 49, and that’s where we measure disease and behavior; most Africans, including Ugandans 15 to 49, are not abstaining. Most of them are, in fact, married and sexually active. But the difference is they’ve become monogamous and faithful. That’s the big change. The second change is the proportion of youth engaging in sex, that went down in a big way between the latter 1980s and the mid-1990s.

Two countries in Africa most effectively mobilized their religious leaders and communities to address AIDS prevention. Those two countries are Uganda and Senegal, and they stand out not only as the two success stories in terms of AIDS prevention, but they also stand out in having less AIDS-associated stigma than other countries in Africa.

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