Abstinence--The Scarlet Letter of the Left

There are few things as political as AIDS and poverty. And sexual abstinence pretty much wipes out both, but since you can't tax it, and it has a religious and moral connotation, it is maligned as impractical at best and unconscionable at worst. Take PEPFAR reauthorization. That's the President's Emergency Plan for AIDS Relief, and the original 2003 act was reauthorized on July 30, 2008. In just 5 years, the treatment with life saving medicine went from 50,000 to 1.73 million, primarily in sub-Saharan Africa. This was applauded even by its critics. However, the most successful focus country in prevention was Uganda, which waged a strong abstinence (Africa style) program. And yes, now the "don't condemn the condom" troops are on full attack against the "zero grazing campaign" of Uganda, which is probably why the 2008 reauthorization caved on the abstinence funding. The powerful pro-abortion groups need more ways to reduce the populations of blacks, whether in the U.S. or Africa, and our new president will certainly be going along with this. According to the Catholic Family and Human Rights Institute

"Uganda’s rejection of the condom-emphasizing approach, also known as the ABC model (Abstinence, Being Faithful, Condoms as a last resort), has earned it the enmity of the orthodox AIDS lobby. AIDS 2008 featured a symposium session chaired by Frances Kissling – the former president of “Catholics for Choice,” who stepped down last year – aimed at discrediting the ABC approach as “ideological.”

Still, the Ugandan model is attracting notice. India’s National Council of Educational Research and Training recently announced that it would embrace the Ugandan emphasis on abstinence and fidelity in its sex education curricula. Significantly, a study authored by a research team headed by Harvard’s Daniel Halperin that appeared in the May 2008 issue of Science magazine, “Reassessing HIV Prevention,” found empirical evidence supporting aspects of the Ugandan approach."

The 2003 requirement that 33% of prevention funds be spent on abstinence-until-marriage programs was removed in the 2008 renewal, reduced to "meaningful support of monogamy and fidelity." Critics consider abstinence and faithfulness programs a distortion of priorities (i.e., Christian moralizing), preferring instead the unreliableness of the occasionally used and leaky condom. Also, groups counseling abortion services may now get funding for HIV services. You will read hundreds of studies and documents saying women and children are at risk from abstinence based programs--but it's rare to see anything that says abstinence is really the only solution.

While western based liberals in both the government and the increasingly politicized medical field have wrung their hands over the "moralizing and constraining spending mandates" of PEPFAR (JAMA, Nov. 5, 2008 p. 2047), Uganda excelled in controlling AIDS by using the common sense approach--the African way. Helen Epstein’s new book, “The Invisible Cure: Africa, the West and the Fight Against Aids" is reviewed and linked at Abstinence Africa which may show just one more way Westerners have misjudged the African culture, particularly polygamy.

"In Africa, HIV spread among ordinary people who were nowhere near as promiscuous as high-risk Western groups such as prostitutes or gay men. By contrast, about 40 percent of Ugandan men and 30 percent of women have ongoing relationships with a small number of people -- perhaps two or three -- at a time. These ‘concurrent’ relationships might overlap for months or years, or even, in the case of polygamous marriages, a lifetime.

As Epstein explains, these concurrent relationships are at higher risk for spreading HIV for two reasons. First, a person recently infected with HIV may be a hundred times more likely to transmit the virus than someone who has been infected for a few months or years. Most Westerners tend to practice “serial monogamy,” having only one partner at a time, and will usually only infect a current partner. By contrast, a polygamous man who becomes infected with HIV is likely to infect all his concurrent partners.

Concurrent relationships are also at higher risk for spreading HIV because the degree of intimacy and trust in these relationships means that people don’t think they need to use condoms. Many faithful African women became infected with HIV because of their husbands’ behavior. Few health officials from international aid organizations were aware of any of this.

Many western AIDS researchers believe that promoting condoms among high risk groups, such as prostitutes and their clients is the best way to slow the spread of HIV. But HIV continued to spread throughout eastern and southern Africa, even when condom use soared. Epstein argues that some of the condom campaigns backfired. “By associating AIDS with beer drinking, premarital sex, prostitution … womanizing and rape, the lusty condom ads ... clashed disastrously with local sensibility concerning decency and self-respect,” Epstein writes. One of her African sources stated bluntly: “The campaigns were totally wrong. The message was you had to be a prostitute or truck driver to get AIDS.”

A Ugandan prevention campaign focused specifically on issues of concurrent relationships. They developed the slogans “Love Carefully” and “Zero Grazing” – meaning, in the words of the head of Uganda’s AIDS Control Program, “avoid indiscriminate and free-ranging sexual relations.” These slogans were posted on public buildings, broadcast on radio, and bellowed in speeches by government officials. The Ugandan Association of Co-Wives and Concubines -- hardly something any Western aid organization would have instituted -- contributed as well. These women policed the behavior of polygamous men, encouraging them to avoid the casual affairs that could endanger all their wives and future children. One of their messages was: “If your husband is unfaithful and is going to kill you with AIDS, you divorce him.”

The result of all this was a steep decline in the number of sexual partners, a basic step in controlling any sexually transmitted disease."

Of course, AIDS gets the focus and money, but that's not what kills most vulnerable African children--it's diarrheal diseases and malaria. In their concern over bird eggs launched by the non-scientist Rachel Carson over 30 years ago, western governments and companies were quickly pressured into removing DDT from the arsenal of weapons in the war against disease before anything else was available (this method continues today in most environmental issues). This killed millions of Africans and disabled millions more. Instead, the missionaries for malaria when viewing the havoc they created, moved to the mosquito condom--the bed net, which probably requires even more care with application than the other type on an eager body part. And of course, installing wells to pump clean water means someone has to take of them. Where's the money in that?

Yes, there's just not much money in clean water, dead mosquitoes and women taking control to guard their own and their children's health through chastity and faithfulness.

And on money, both the left and the right can agree.