Why Condoms Will Never Stop AIDS In Africa
by Sue Ellin Browder - May 31, 2006
Reprinted with permission from our good friends at InsideCatholic.com, the leading online journal of Catholic faith, culture, and politics.
Every ten seconds, a man, woman, or child in Africa dies from an AIDS-related disease. According to the USAIDS/World Health Organization (WHO), 40.3 million people now live with HIV infections, two-thirds of them in sub-Saharan Africa. In Swaziland, 42.6 percent of pregnant women test positive for HIV.
There's no cure for this killer, and no end in sight. The United Nations predicts that if present trends continue, AIDS will claim an additional 65 million lives by 2020-more than triple the number of those who died in the first 20 years of the pandemic.
It has been five years since New York Times columnist Bob Herbert wrote that most of us are simply unable to grasp the enormity of this disaster. "We are in the early stages of an unprecedented threat to the health of the human species," he warned. "The long dark night of AIDS has just begun."
Promoting Condoms Without Evidence
In response to this unimaginable tragedy, AIDS experts have long had one simple, first-line solution: Use condoms. Indeed, since 1989, at least 4 billion condoms have been shipped to sub-Saharan African nations in the belief that they'd stem the spread of the disease.
So here's the surprise: According to the latest research, condom promotion is ineffective for anything but lowering the rate of AIDS in concentrated, high-risk groups, like homosexuals in San Francisco or prostitutes in Bangkok. Condoms have never been shown to reduce HIV infection rates and AIDS deaths in general-population epidemics like those in sub-Saharan Africa. Paradoxically, the more condoms AIDS activists send to Africa, the more widespread the disease has become.
This has not escaped the attention of health researchers. Armed with solid evaluations of the effectiveness of condom promotion programs in sub-Saharan Africa, the world's most knowledgeable AIDS experts are reaching a new consensus: Condoms have their place, but they're not the magic bullet scientists once believed them to be. "We need to understand there are different kinds of AIDS epidemics," says Dr. Edward C. Green, a medical anthropologist and senior research scientist with Harvard's School of Public Health. What's more, he adds, "When it comes to AIDS epidemics, one-size-fits-all health prescriptions don't work. Different types of AIDS epidemics require different solutions."
In the November 27, 2004, issue of the prestigious British medical journal The Lancet, more than 150 of the world's leading AIDS scientists and other experts in AIDS prevention and treatment signed a statement in which they declared that "the time has come for common ground" on preventing HIV/AIDS. Of the three interventions scientifically shown to prevent AIDS-abstinence, being faithful, and using condoms-they argue that the use of condoms clearly comes last and should be promoted as a first-line defense only to those in extremely high-risk groups, such as commercial sex workers.
"Fortunately, we can now move beyond debating how well condom promotion might work to examining how well it has worked," says Dr. Norman Hearst, a family and community medicine professor at the University of California, San Francisco.
