23 Comments on “Screwing Africa Without a Condom”   rss feed

1. Charles Martel on Dec 1st, 2005 at 1:44 am

   Mark: Pardon my intrusion, but is this so-called “abstinence-only” education primarily focussed on abstinence from heterosexual intercourse, or abstinence from homosexual contact? Based on the references to pregnancy and the general tenor of the post, I guessed the former. If so, then I believe that this issue is largely moot, as the danger of AIDS transmission through heterosexual channels is quite small, and almost impossible from female -> male. In other words, condoms are good for preventing pregnancy, but play little role in preventing AIDS, at least via heterosexual intercourse. Of course, both the political Right and political Left share some blame in promoting fear of heterosexual transmission — the Left because they want to tell us that all types of sexual activity are equal (they’re not; homosexual intercourse is far more risky); the Right (of which I am a member) because they want to tell us that all types of sexual activity are wrong.

   That said, if one wants to consider why parts of Africa are being ravaged by AIDS, one should first look to the prevalence of homosexual acts, drug abuse, and the disgusting practice of female genital mutilation (as this can increase the transmission risk of heterosexual intercourse). But I guess that W makes a more convenient target for diatribes.

   Sincerely,
   A reason-based conservative

2. Sean on Dec 1st, 2005 at 2:50 am

   Charles, who cares? The interesting thing about abstinence is, you’re not “heterosexually abstinent” or “homosexually abstinent” — you’re just not having any sex. And pretending that telling people not to have sex is an effective HIV-prevention strategy is criminally negligent.

   I would say that, if one wants to prevent the spread of AIDS anywhere, one should first look to not doing something phenomenally dumb, like abstinence-only programs. Which makes, yes, W an extraordinarily convenient target for diatribes, as he can very reliably be counted on to do the wrong thing.

3. A.J. on Dec 1st, 2005 at 3:21 am

   . In other words, condoms are good for preventing pregnancy, but play little role in preventing AIDS, at least via heterosexual intercourse.

   Condoms go a long way towards keeping women from being infected by their male partners. Funny that you didn’tthink this was worth mentioning.

4. Joe Bolte on Dec 1st, 2005 at 3:39 am

   Hi Charles,
   Sean’s response already points out how your question is moot. But your assertions about relative transmission rates still set off my bullshit detector nonetheless. Please see http://www.hopkins-aids.edu/publications/report/may00_1.html and search for the phrases “nearly identical” and “most common mode of transmission”. Once you have some true facts to go with your reason, I’m sure you’re opinions about Africa’s problems will change.

5. Joe Bolte on Dec 1st, 2005 at 3:41 am

   “your opinions”

   Let this be a lesson to you all. Don’t drink and post.

6. Sometimes Saintly Nick on Dec 1st, 2005 at 6:12 am

   Thank you for sharing. I have been scanning today’s blog posts regarding AIDS and I find yours to be one of the most informative.

7. INT on Dec 1st, 2005 at 7:11 am

   Charles said: AIDS transmission through heterosexual channels is quite small, and almost impossible from female -> male……..

   After this pill of “wisdom” ……. What can I say….. ^o)

8. Uncle Al on Dec 1st, 2005 at 12:29 pm

   A specific example is provided by Uganda, which used to be the poster child for AIDS programs in Africa, and which has suffered a recent setback that is at least partially linked to a decrease in the availability of condoms due to US policies.

   Liberal: One who believes syphilis and HIV are spread by lack of funding. Engineer: One who efficiently designs to achieve an objective goal.

   US policy - education, rights, HIV, war - is Liberal. US policy is about process not product. Physical reality only respects engineering. Solution of a probem is product not process. Problems vanish double quick at no incremental cost when the Gifted proceed unhindered and the crippled proceed unaided. Neither strategem requires bureaucratic oversight.

   We have purchased at astounding cost a future 2(pi) steradians opposite to its engineering solutions. Said future has been delivered fully assembled and its shipping crate is opening. An advocate makes virtue of failure. The worse the cure the better the treatment - and the more that is required. How can any Liberal complain?

9. Frank on Dec 1st, 2005 at 4:36 pm

   Considering how many females in Africa have contracted AIDS, I seriously doubt that you can blame it all on “homosexual contact.” Unless every single African male is “on the downlow,” at least some African males must have contracted the disease from a female partner and spread it to others.

10. Belizean on Dec 1st, 2005 at 4:39 pm

    And pretending that telling people not to have sex is an effective HIV-prevention strategy is criminally negligent.

    Sigh…, this is an absurd statement. 1) Abstinence-only programs never tell people not to have sex. They tell them to have sex under restricted circumstances. 2) Urging behavior modification is an effect means of combating a situation due entirely to behavior.

    If you want to understand how experts in the US see this, see what Planned Parenthood has to say.

    Using as a source of “expert” knowlege a Leftist organization in the abortion business — and therefore having a pecuniary interest in the continuation of ineffectual contraceptive methods — is not particularly persuasive.

    It is an established scientific fact that abstinence only programs do not work.

    It is not an established fact. It is at most a published “finding”. One shouldn’t place much stock in politicized findings (that generally support the position of the author/funder). Especially when they sharply contradict common sense. It is clear that the hetrosexual AIDS problem in Africa would all but disappear if the continent was converted to, say, Presbyterianism.

11. Mark on Dec 1st, 2005 at 6:18 pm

    I love it when people actively write “sigh”. So cute!

    Belizean. No, I don’t think it is an absurd statement. It is established that the strategy of abstinence only approaches to preventing HIV does not work. Therefore, in my opinion, pretending that they do work is ridiculous and, given the lives at stake here, I do not think the phrase criminally negligent is out of place, at very least in spirit.

    Your statement about Planned Parenthood is plain silly and referring to them as being in “the abortion business” is deeply offensive. I know people who work for them and your characterization couldn’t be more wrong. Their recommendations are based on research that is blind to superstition or ideology, as they should be.

    I do not think the findings contradict common sense. Young people are constantly told not to have sex (or, if you like, to have it only when married to that perfect person with whom they will spend the rest of their life) and they routinely ignore this advice. Sensible contraceptive techniques help to avoid pregnancy and condoms are by far the best current hope at avoiding the transmission of STDs, including HIV.

12. Charles Martel on Dec 1st, 2005 at 10:57 pm

    Sean calmly opined:

    Charles, who cares?
    =====
    We should care because unless we consider what actions X are most likely contributing to results Y, we will not do a very good job at preventing Y. If Y is HIV and X is sexual activity, then X is dominated by homosexual contact.

    And pretending that telling people not to have sex is an effective HIV-prevention strategy is criminally negligent.
    =====
    You will have to forgive me, as my views may not be as sophisticated and nuanced as yours. (All those years at a university, and still the Ministry of Truth has failed to completely re-engineer my mind.) But, if sexual activity (of whatever sort) is the primary transmission channel for HIV, then doesn’t limiting one’s own sexual activity make it far less likely that they are going to contract HIV? Sounds pretty simple. In the same way, the government tells me that if I do not pay all of my taxes, I will be subject to prosecution. Since I do not want to be prosecuted, I minimize the chances of that happening by paying my taxes in full. It’s worked so far. But keep your fingers crossed for me.

    I also do not like the insinuation that we are animals unable to control ourselves. We can choose what we do and do not take part in — so long as we are educated about the X’s and the Y’s (see above). In short, while sex is an instinct, we are capable of controlling our instincts. I, for one, always appreciate the challenge.

    Mark blushed:

    Your statement about Planned Parenthood is plain silly and referring to them as being in “the abortion business” is deeply offensive. I know people who work for them and your characterization couldn’t be more wrong.
    =====
    Aren’t businesses always interested in selling you their most expensive product/service? (At least that is what I usually hear from anti-capitalist talking heads.) It’s just a hunch on my part, but I’d bet that abortion is PP’s most expensive service.

13. Arun on Dec 1st, 2005 at 11:10 pm

    …that we are animals unable to control ourselves

    Just what are we? A bit of the crass and a bit of the sublime?

14. Mark on Dec 1st, 2005 at 11:36 pm

    Charlie. I read what you said that your “views may not be as sophisticated and nuanced” as ours and thought I was getting your sarcasm. Then I read what you had to say and realized you were serious.

    First, nobody is disagreeing with the statement that if you don’t have sex you’ll dramatically reduce your chances of getting HIV. However, it is not the relevant question. The right question is whether telling people to practice abstinence works. It doesn’t. You just look at the input and the output and see if one gets the required effect. You don’t get to look at the ideal way you’d like it to work and declare the method a keeeper.

    Secondly, without blushing again, Planned Parenthood is not a business and either you know it or you should blush that you don’t

15. exalen on Dec 2nd, 2005 at 1:48 am

    I’m with Mark on this one.

    The problem here is that we have people from one country trying to impose their ideologies on another country.

    Charles said, “We can choose what we do and do not take part in — so long as we are educated about the X’s and the Y’s (see above). In short, while sex is an instinct, we are capable of controlling our instincts. I, for one, always appreciate the challenge.”

    Now in the puritanically rooted US, with its first-world resources and ‘educated’ society, abstinence may work, and people can exercise their right to choose to do certain things.

    But in Africa, it a totally different situation. Half the people having this argument have never seen the poverty and the way people actually survive in these countries first-hand. (Note: I use survive as opposed to live.) They haven’t seen the lengths that people go to in order to ensure their survival for the next 24 hours. Many don’t have the luxury of thinking more long term than that.

    Where the act of sex is seen as recreation to you, in some parts of the world it’s a commodity, it’s a weapon, and for some people it’s the only thing they can do to get a couple of cents to buy a handful of rice.

    Rape is rampant. Rape of men, women and even children. People who have the disease (HIV/AIDS) aren’t being properly educated, due to unrealistic programmes like the one being discussed here, and so are believing superstitious cures. And so it spreads.

    It’s all well and good to say, “I think abstinence is a good way to not get AIDS.” But then again, you’ve probably never had to forage through trash to find something to eat, you probably weren’t born with the possibility of having HIV yourself then have to watch your parent(s) die from it when you were three. If you’re a girl, you probably never lived with the VERY REAL threat of being raped BECAUSE you are a virgin and someone told a HIV+ guy (who you’ve never met) that you are his cure.

    So next time you see the sad face of that hungry child on TV, look in the background and take a reality check. That is the world you are trying to impose your white-bread beliefs on. To these people your life is akin to the royal families of Europe.

    Condoms work. Uganda’s progress proves that. They may not address the whole problem, but they make a significant impact. And this impact is measured in lives.

    Sure, tell people that abstinence will keep them safe. But we also need to arm them with the knowledge of what this disease is and how to minimise risk in all situations… and yes, that involves condoms.

    Also, heterosexual sex has just as much risk associated with contracting HIV as homosexual sex. It’s almost 2006, people, stop living in the 80’s.

    “Your moral ideals aren’t saving my life.”

16. Mark on Dec 2nd, 2005 at 8:12 am

    I basically agree exalen. Just one thing to add. These silly abstinence only policies don’t work here either. This is also well-known, but ignored by the religious right. See what’s happening with growing HIV infection rates (particularly among black women) in parts of the South (like Alabama).

    It’s not really a problem of us imposing solutions that work for us on a different culture where they won’t work. Rather it is just (a) a silly idea from the start and (b) more importantly, an approach that has been shown to fail.

17. Charles Martel on Dec 2nd, 2005 at 9:20 am

    Exalen expounded:

    The problem here is that we have people from one country trying to impose their ideologies on another country.
    =====
    I suspect that you would label abstinence as an ideology (even though I made no “moral” arguments about abstinence), and condom use as a strategy. But, aren’t you imposing your views on another country by telling the people to use condoms? You will say that condoms work and abstinence does not, but that does not change the fact that you are taking part in what some in the Academy like to call “cultural imperialism”.

    Where the act of sex is seen as recreation to you, in some parts of the world it’s a commodity, it’s a weapon, and for some people it’s the only thing they can do to get a couple of cents to buy a handful of rice… Rape is rampant. Rape of men, women and even children…. If you’re a girl, you probably never lived with the VERY REAL threat of being raped BECAUSE you are a virgin and someone told a HIV+ guy (who you’ve never met) that you are his cure.
    =====
    Okay, you argue that this grim situation makes it unlikely that people are going to be convinced to stay abstinent. But according to your same argument, it would seem equally unlikely that such people are going to use condoms. Is the guy who thinks that having sex with a virgin would cure his HIV be convinced? What about those rapists? Will they put on a condom before raping? Instilling the importance of abstinence or the importance of condom use both require education — yet the difficulty in educating the continent is what you cite as an argument for condoms over abstinence. That, my friend, is not a logically consistent position.

    Also, heterosexual sex has just as much risk associated with contracting HIV as homosexual sex. It’s almost 2006, people, stop living in the 80’s.
    =====
    As Mark might say, this idea is not “reason-based”. Consider this CDC report, which claims that only 35% of new HIV cases are due to heterosexual transmission. Since we are told that about 95% of the population are heterosexual, a bit of math would indicate that homosexual contact is far, far riskier. I am sure that an anatomist would tell you the same thing.

18. Arun on Dec 2nd, 2005 at 1:13 pm

    http://allafrica.com/stories/200511230646.html

    is worth reading. I haven’t had the time, but presumably

    http://www.unaids.org/Epi2005/doc/EPIupdate2005_html_en/epi05_00_en.htm

    is worth reading as well. Skimming one of the Africa sections:

    Changes in sexual behaviour appear to have contributed to the declines in HIV prevalence. Condom use within casual partnerships has reached high levels (86% among men, and 83% among women) and data from recent national and local surveys indicate that there could have been a reduction in the reported number of sexual partners in recent years (Mahomva, 2004)

    and this

    What happened in Uganda?

    Recent findings from a multi-year (1994–2003) study of 44 communities in Rakai in the south of country have helped refine understandings of the progression of Uganda’s epidemic. HIV prevalence declined sharply—among women from 20% in 1994-1995 to 13% in 2003, and among men from 15% to 9% over the same period. Generally in Uganda, such declines have been attributed to behavioural change. However, in Rakai, evidence of such change has been uneven, with researchers observing no significant increases in abstinence or fidelity. The proportion of teenagers who say they have had multiple non-marital partners has increased considerably (from under 25% in 2000, to almost 35% in 2003. Condom use with casual partners, however, is now more commonplace—especially for men—and has probably helped lower HIV prevalence (Wawer et al, 2005). However, most of the momentum for Rakai’s decline in prevalence appears to have derived from higher mortality rates—to such an extent that researchers’ calculations suggest that approximately 5% of the observed 6.2% decline in HIV prevalence in 1994–2003 in Rakai was due to increased mortality.

    It is unclear whether or to what extent the trends observed in Rakai have played out elsewhere in Uganda. In Masaka district (next to Rakai), for example, declining HIV incidence in the 1990s appeared to correlate strongly to behaviour change (Mbulaiteye et al., 2002). However, in Rakai (and in other areas of the country) there are tentative signs of a possible resurgence of HIV incidence among young men and women (aged 15–24 years). These trends underline the need for revitalized HIV prevention strategies (Wawer et al., 2005).

    Since discussions do best when there is real data to pore over, I thought these to be relevant.

19. Mark on Dec 2nd, 2005 at 1:54 pm

    Thanks Arun, I’ll add these to the rest of the data I’ve beeen poring over.

20. Annie on Dec 2nd, 2005 at 6:47 pm

    Charles — certainly you realize that the report to which you linked contains information on only 29 of the United States. None of these, to my knowledge, are in Africa.

    To the discussion at large — I also think it’s worth pointing out that, whatever one thinks about abstinence-only programs, there’s a huge difference between saying to an American teenager, “Don’t have sex until you’re married” and saying to an African person of any gender, age, or sexual orientation, “Don’t have sex. Period.”

21. exalen on Dec 2nd, 2005 at 7:32 pm

    Mark, my argument is not “give everyone condoms.” My argument is for a campaign to educate people so that they know what it is they are dealing with, so that they know what to do when they choose to have sex, and so that they know that those superstitious cures won’t work.

    Pushing one angle, abstinence, to the detriment of all others is homicidal behaviour. Its like telling kids that they shouldn’t ride a bike till they are ‘ready’ (whatever that is), and not teaching them about road safety and helmets.

    It’s not imperialism when you give people all the information. It is imperialism when you only push one (your) agenda.

    I mention ideology, not because of you specifically saying it, but because the institutions who are making these demands are ideologically based.

22. exalen on Dec 2nd, 2005 at 7:33 pm

    OK… so that last one was addressed to Charles Martel, not Mark.

23. Pingback from Musings on World AIDS Day: BLOG: SciAm Observations on Dec 6th, 2005 at 9:01 pm

    [...] This year, the U.S. extended the gag rule, cutting off money to programs that do not condemn prostitution and, most recently, to at least one HIV/AIDS program. Meanwhile, the U.S. pours money into the promotion of sexual abstinence to the detriment of condom distribution–a strategy disavowed by 22 European nations last week. [...]

Comments are currently closed.