Was Pope Benedict XVI right about condoms and AIDS?

Jack Bloom writes that it is greater faithfulness which halts the spread of the epidemic

Pope Benedict XVI was loudly denounced when he reportedly said on his trip to Africa that condoms were not a solution to the AIDS epidemic, but would worsen the problem instead.

A representative of the AIDS Healthcare Foundation said "The Pope should be offering constructive real world solutions to the global AIDS epidemic and not distracting us from the single most effective prevention tool we have today: condoms."

The Pope's position was actually more subtle than reported, and his critics need to examine more closely the evidence for condom effectiveness..

Gauteng is a good case study as more condoms have been distributed here in relation to population than anywhere else on earth.

According to official figures, in the last 9 years, about a billion condoms have been distributed in the province. The official target is to distribute 160 million condoms a year.

This is an astounding figure, but has had little effect in preventing HIV/Aids, nor has a massive education campaign and other interventions.

In 2000, HIV prevalence amongst pregnant women attending public antenatal clinics in Gauteng was 29.4%, and it was 30.3% in 2007.

About 100 000 people become newly infected with HIV/Aids every year in Gauteng, despite the endlessly promoted AB C prevention message (Abstain, Be faithful and Condomise).

I suspect that the condom message has overwhelmed and undermined the abstention and fidelity options that were the most successful in dramatically reducing HIV-infection in Uganda from 18% to about 6 percent.

Medical researcher Dr Rand Stoneburner attributes the decline in HIV/Aids infection in Uganda to fewer non-regular partners among the unmarried, and a higher degree of fidelity within marriage.

In 1995, just under 20% of Ugandan males had non-regular partners in the last 12 months, whereas in the comparison countries the figure was around 60 percent. Only 5% of Ugandan females had non-regular partners, while in Kenya , Zambia and Malawi the figures were over 30 percent.

Condom use was much the same in all four countries, therefore it was not the critical factor that made the difference.

Stoneburner calls the Ugandan intervention a "social vaccine" that was "better than any bio-medical approach to date", and notes that it had been introduced before the large-scale marketing of condoms.

A correctly used condom is obviously a barrier to the transmission of infectious fluids, but could easily engender a false sense of security that leads to risky sexual behavior such as multiple partners.

For various reasons, including alcohol, an available condom may not be used in all these sexual encounters.

It is a worrying sign that the age of first sex has been declining in South Africa rather than rising as occurred in Uganda.

Surveys reveal enormous peer pressure amongst teenagers to have sex. In one Gauteng study, 37% of schoolchildren reported being forced to have sex.

I agree with National Health Minister Naledi Pandor's rejection of calls for condoms to be made available in schools as it sends out completely the wrong signal.

It would contribute to the shocking attitudes revealed by youths interviewed in one study who thought it quite normal to have multiple sexual contacts.

One girl was the "important" partner, and "being faithful" was all about protecting her feelings, so it was fine to have other girl friends so long as it was secret. There was little thought of intimacy, love or respect for the lesser bed-partners.

Pope Benedict's actual words were: "if the soul is lacking, if Africans do not help one another, the scourge cannot be resolved by distributing condoms; quite the contrary, we risk worsening the problem. The solution can only come through ... the humanisation of sexuality, in other words a spiritual and human renewal bringing a new way of behaving towards one another."

Condoms or no condoms, if we constantly reduce sex to biology rather than committed relationships, we will never change the risky behaviour that drives our Aids epidemic.

Jack Bloom is leader of the Democratic Alliance in the Gauteng legislature. This article was first published in Rising Tide, his weekly email newsletter.

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