Thursday, March 24, 2005

On HIV/AIDS and the Success of the ABC Strategy:
GE M 05:03:23a

On the Let's Talk programme, we sometimes let remarks stand without direct rebuttal; especially if the programme as a whole provides adequate balance. However, if such remarks are later sliced out of context and presented publicly as the bottom line on the topic, a few balancing words are then quite in order.

Regrettably, such a corrective is plainly now needed on the topic of the Church's morally based stance on the HIV/AIDS global epidemic and on the related success of Uganda's ABC campaign.

First, let us hear Moses on why biblical morality "works":

". . . what does the LORD your God ask of you but to fear the LORD your God, to walk in all his ways, to love him, to serve the LORD your God with all your heart and with all your soul, and to observe the LORD's commands and decrees that I am giving you today for your own good?" [Deut. 10:12 - 13]

So, Heb 13:4 -- "marriage should be honoured by all, and the marriage bed kept pure, for God will judge the adulterer and all the sexually immoral" -- should be seen in that light: our Creator's commands are meant to protect and bless us and our community, so ignoring them can have sadly devastating consequences for us, for our loved ones, and for the wider community.

But, equally, as Jesus pointed out: none of us is without sin, so instead of throwing stones at one another, each of us should ask God to help us take the planks out of our own eyes and reach out a helping or comforting hand. [Jn 7:53 - 8:11, Matt 7:1 - 5.]

Secondly, a recent (and unfortunately flawed) Columbia University study on Uganda may have led some to think that the A and B parts of the ABC strategy don't work in the real world. However, as the Harvard-based AIDS researcher Dr Edward Green observed just a few days ago:

"[condom use] went up in every country in Africa and in several countries condom user levels went higher than Uganda and [HIV/AIDS] infection rates didn't come down, they went up. We know the statement that condoms worked is not true. Then there's another claim: When people die off, prevalence goes down because of death. That's also not true because infection rates and levels of death, however you want to measure them, have gone up higher in other African countries and prevalence hasn't come down . . . . It went down uniformly throughout Uganda." [CT interview Mar 7 05, ]

That is, as Dr Green also noted, the best explanation for Uganda's success remains: "Most behavioral change [towards Abstinence and Fidelity] in Uganda was in the latter 1980s and early 1990s . . . . So the incidence rate started going down in the later 1980s and early 1990s and then it's the dynamics of epidemics that even if you don't really do anything after that, prevalence continues to go down for a number of years . . ."

In short, ABC did and does work. And, more specifically, while condoms are significantly (but not perfectly) effective as barriers to the passage of the HIV virus, the Uganda epidemiological evidence shows strongly that the A and B parts are the real keys to its success. So, let us heed the bottom-line lesson for the Caribbean: a balanced ABC strategy is both morally sound and epidemiologically sound. END

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