Earlier this year, the journal PLoS
Medicine
published a
stunning report
about the prevalence of AIDS in Zimbabwe. Over the
ten years to 2007 HIV prevalence was halved. This decline is almost unique in
sub-Saharan Africa.

Aha! you might say. Despite the disastrous
state of its economy, Zimbabwe has been distributing condoms by the millions to
bring down adult prevalence from 27 percent to 16 percent. But you would be
quite wrong. It is not condoms which are saving the lives of thousands of
Zimbabweans, say researchers, but changes in behaviour, “mainly reductions in
extramarital, commercial, and casual sexual relations”.

In other words, it looks like abstinence
and fidelity are the secret to turning around the devastating AIDS epidemic
which has killed 30 million people and infected 33 million and orphaned 16
million children.

Not condoms.

This report supports the thesis of the authors of the
fascinating book Affirming Love, Avoiding AIDS, Matthew Hanley and Jokin de
Irala. The orthodox view of fighting AIDS assumes that it is nearly impossible
to change people’s behaviour. Therefore, condoms and counselling about safe sex
are the best weapons. Bureaucracies in the United Nations and in government
health departments argue strongly that abstinence, fidelity and monogamy are impossible
for Africans. Columnist Nicholas Kristof even wrote in the New York
Times
that “The stark reality is that what kills young women here is
often not promiscuity, but marriage. Indeed, just about the deadliest thing a
woman in southern Africa can do is get married.”

This is complete twaddle. Hanley and de
Irala show that “primary behaviour change” is the best weapon for fighting
AIDS, not “harm reduction”. In fact, the rapid spread of AIDS in sub-Saharan
Africa, despite a thorough understanding of how it spreads and billions spent
on risk reduction, is “one of the greatest failures in the history of public
health”. The South African strategy assumed, for instance, that the spread of
AIDS has little to do with sexual responsibility. Authorities there promoted
condoms with a “have fun but play safely” campaign. The results have been
disastrous. About 18 percent of men and women between 18 and 49 live with HIV/AIDS.

The AIDS bureaucracy is committed to technical
fixes despite lip service to abstinence and fidelity. Condoms, voluntary
counselling and testing and treatment of other sexually transmitted diseases
are their strategies. All of these are effective to some degree, but they
ignore mounting evidence that HIV transmission rates remain high despite
widespread distribution of condoms. In Botswana, the authors point out, condom
sales increased from 1 million in 1993 to 3 million in 2001, while HIV
prevalence rose from 27 to 45 percent among pregnant urban women. Between 1990
and 2002 life expectancy fell by 30 years in Botswana, a decline “unprecedented
in the history of the human race”.

Why don’t condoms work? It’s not a question
of permeability or breakage, but of how they are used. For one thing, only
consistent condom use is effective in warding off AIDS. Yet it appears that
most men use condoms very irregularly. And the evidence is mounting that condoms
actually promote risky sexual behaviour because users feel that they are
protected.

The engine of the epidemic is multiple sex
partners, a growing number of AIDS researchers believe. When people have
stopped engaging in casual sex and participating in a web of sex relationships,
as has happened in Uganda and Zimbabwe, AIDS rates have fallen dramatically.

The real question, then, is why have public
health officials been so blind? This is the main contribution made by Hanley
and de Irala in their extensively documented book. They frame the debate over
HIV prevention as a clash between two views of human sexuality. The
Judaeo-Christian view believes that self-restraint and reserving sex for
marriage leads to fulfilment and well-being. But the modern Western view
condemns limits, exalts the autonomous pursuit of pleasure, and believes that technology
will remedy any ensuing problems.The AIDS bureaucracy is fully committed to the latter.

In their opinion, the best-informed research
vindicates the Catholic Church’s stand on AIDS – that, as Benedict XVI said in
2009, “the scourge cannot be resolved by distributing condoms; quite the
contrary we risk worsening the problem.” This was condemned as heartless
ideological blather by the media. But Hanley and de Irala contend that it is
the only view worthy of human dignity.  

“The Church’s
view that all people have the capacity to change stands in conflict with the
AIDS Establishment’s view that people are powerless victims of passions and
circumstance. The entire harm minimization, or risk reduction approach, however
technically sophisticated or bureaucratically cumbersome it comes to be,
ultimately depends on this latter, deeply condescending view of the person…

“It confirms low
expectations about the possibilities of human behaviour and tacitly concedes
the inevitability of destructive behaviours. Not to acknowledge the ability of young
people and adults to respond to messages about abstinence and fidelity in a
context that affirms the precious gift of human sexuality is ultimately a
disservice.”

The AIDS bureaucracy is pressing ahead with
its campaign to throw condoms at the epidemic. In June to mark the 30th year
since AIDS was first identified, the United Nations General Assembly gave the
most explicit UN backing yet to the use of condoms. Instead of talking simply
about the importance of abstinence and fidelity, the statement stresses the
“correct and consistent use of condoms.”

“We are very happy about this,” said George
Tembo
, head of the AIDS/HIV department at the UN Population Fund.
“It is very explicit and will definitely help our work to overcome resistance
and fears about condoms.”

The madness continues. Could someone send
him a copy of Affirming Love, Avoiding AIDS?

* “Affirming Love, Avoiding AIDS” has just been awarded first place in the best book by a small publisher category by the Catholic Press Association. 


Michael Cook is editor of MercatorNet.

Michael Cook

Michael Cook is the editor of MercatorNet.