The Reality of AIDS - Part 12 - A Case for Abstinence

Perhaps the most authoritative voice on the subject of abstinence as a tactic for stemming AIDS proliferation comes from Edward C. Green, a research scientist at Harvard University and author of Rethinking AIDS Prevention. In 2003, the US Agency for International Development (USAID) asked the sociologist to study the long-term benefits achieved through the various AIDS prevention methods in Africa. When it was submitted, USAID shelved Green’s report and hired a condom advocate to conduct a further study which it ultimately accepted. Green had concluded the “ABC method – abstinence, being faithful in marriage and Condoms only for high–risk populations – was most effective in the dramatic reduction of AIDS cases in Uganda.

“We have in our possession a social vaccine,” Green said, referring to a point made by fellow AIDS researcher Rand Stoneburner, MD, MPH. “The biomedical vaccines we talk about for AIDS have been 10 years away for 20 years. They’re still far away and no one is expecting such a vaccine to be more than about 35 to 40 percent effective when and if we get one. In fact, a new, more aggressive strain of the AIDS virus has just recently emerged. But, as Stoneburner has been saying, we already have a social vaccine promoting partner reductions, fidelity, monogamy, abstinence.”

Green at first focused on the facts in Uganda in 1993 when he was a social engineer and self-avowed condom advocate. He says he was stunned to see infection rates were falling because of something other than condoms. “Nobody believed that the rates were coming down and nobody believed that it had anything to do with abstinence and faithfulness,” he said. I said to USAID in a report that’s published in my book ‘Ah! Look, they’re doing something different and it’s working. My recommendation was to put more resources into abstinence and faithfulness.’ Those recommendations were ignored until Green’s findings caused George Bush to issue the President’s Emergency Plan For AIDS Relief (PEPFAR) in 2002, a program designed to push abstinence.

Green cites a parallel situation: “You would advise young people not to start smoking and say to others: If you already smoke, consider giving it up or at least have fewer cigarettes per day,” he said. “But for the last 20 plus years we have not been able to say that about sexual behavior. We haven’t been able to talk about sexual behavior like, ‘If you’re young, don’t start until you’re married and, if you’ve already started, stick to one partner. Don’t have dozens or scores or hundreds of partners.’ In any infectious disease, you want to limit your number of contacts. How do you limit your contacts when it comes to something that’s sexually transmitted except with fidelity and abstinence?”

“There is a trend in Africa toward abstinence and fidelity despite lack of funding for that sort of promotion,” Green said. “Though faith-based organizations have been the major voices for abstinence in Uganda, they have been sidelined. Almost none of them have been funded by major donors, or major organizations that fund AIDS programs. We found that if you ask people in those countries why they’re choosing those methods, it’s typically because some religious group told them they have to do it or they’ll die. Such blatant truth-telling is stemming the tide of the AIDS epidemic in some African nations.”

Such recognition is even happening in the U.S. The on-line fact sheet on condoms issued by the Centers for Disease Control and Prevention used to begin with this statement: “Condoms are effective in preventing HIV and other STDs.” The fact sheet was removed from this website site in 2002 and was later replaced with one that states: “The surest way to avoid transmission of sexually transmitted diseases is to abstain from sexual intercourse or be in a long-term monogamous relationship with someone whom you know is not infected.”