Condoms & AIDS Crisis: A solution?

The solution to the global AIDS crisis is NOT the provision of condoms. Why not?

Well, according to the UN AIDS council, condoms have a 10% failure rate in their prevention of HIV, even when used consistently. And, as shown in a study published in the American Journal of Epidemiology, they reduce risk of HIV posed by homosexual anal sex by just 47%. This would be bad enough, but condoms are rarely used consistentlyfurther reducing their already less-than-stellar effectiveness.

Part of the problem is that the use of condoms leads to Risk Compensation – a phenomenon in which the use of risk-reducing technologies makes individuals more willing to take on greater risk. (For instance, the use of sunscreen makes us more willing to spend long hours in the sun, just as the use of seat-belts make us more willing to drive recklessly.) In a 2006 study published in the BMJ, it was shown that condom users may disproportionately erase the benefits of condoms with riskier behavior, that is, individuals may  take greater sexual risks when using condoms, and thereby erase any protective benefit the condom may have provided.

Now in theory, condoms should help. And no one would deny that in a single, isolated incident of sex they do reduce your risk of HIV. But life is not made up of single, isolated, laboratory-worthy incidents. In reality, and over time, the mass distribution of condoms has no effect on AIDS epidemics. This was confirmed by the study Reassessing HIV Prevention, in which 10 AIDS experts made clear that “consistent condom use has not reached a sufficiently high level, even after many years of widespread and often aggressive promotion, to produce a measurable slowing of new infections in the generalized epidemics of Sub-Saharan Africa.”

James Sheldon of the US Agency for International Development notes this in his analysis Confessions of a Condom Lover, published in The Lancet: “In South Africa, for example, with 48 million people in 2004, public programmes provided 346 million condoms, and condom use at last sex was high, especially among single people aged 15—24 years (69%). Yet infection continues apparently unabated.”

Compare such results to the story of Uganda. Their government and religious leaders focused not on condom distribution, but on the promotion of monogamy. According to analysis published in Science Magazine, by 2004, “despite limited resources, Uganda has shown a 70% decline in HIV prevalence since the early 1990s, linked to a 60% reduction in casual sex.”

Or to the story of Kenya. According to Sheldon, the country’s rate of infection dropped throughout the 1990’s at the same time the number of men with multiple sexual partners dropped. The evidence seems to suggest that it is the promotion and practice of monogamy, not condom distribution, that will rid our world of the scourge of AIDS.

Thus the answer to the problem of AIDS is neither the “conservative” response — “Abstinence or you’ll die!” — nor the “liberal” response — “More free condoms!” No, the answer to the problem of AIDS is a human one: Live monogamy, and you’ll save the world.



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