Condoms will not stem the tide of HIV infections - life changes are needed

Sarah Henderson's faltering faith (Herald Sun, January 14, 2004) distorts Catholicism, but her belief that "condoms fight HIV" is also bad science. Why does Sarah indulge in ageism - aren't the opinions of an 83-year-old pope who fought Nazism and played a major role in the defeat of the Soviet Union, worth as much as those of a middle-aged (sorry, Sarah!) Melbourne company director? John Paul II is physically frail but his mind is clear, and one wonders why those who resent his views do not join a denomination which would give them all they want - abortion, contraception, extra-marital sex, condoms and homosexual clergy, e.g. the Uniting Church. Sarah, Monica, Peg et al could even start a church of their own - a church with a condom-shaped steeple for instance.

The Catholic Church does not abhor gays - hate the sin, love the sinner is the guiding principle - it shows compassion, offers prayers and counselling. Indeed it may well have been because the Church was too tolerant of those with a homosexual orientation among its clergy that it has been plagued with the epidemic of child abuse, much of it of adolescent boys by homosexuals. This would not have been reduced by a married clergy, as is apparent from similar cases in the Anglican Church.

At a conference in Washington DC this month on the "ABC (Abstinence, Behaviour, Condoms) Approach to the HIV Pandemic", medical experts were critical of the insistence by some NGOs and policy makers that the "C" (condom) approach will stem the tide of HIV. They claimed that the availability of condoms statistically increases promiscuity and risk of contracting HIV.

Dr. Edward C. Green, Harvard's Centre for Population and Development Studies, said: "20 years into the pandemic there is no evidence that more condoms leads to less AIDS. We are not seeing what we expected: that higher levels of condom availability result in lower HIV prevalence." Dr. Norman Hearst, University of California, supported this analysis with statistics from Kenya, Botswana, and other countries, which show an alarming pattern of increased condom sale correlating with rising HIV prevalence by year.

Promotion of the "safe-sex" message has reportedly increased numbers of sexual partners. Green said the spread of HIV is a behavioural problem:

"Having multiple sexual partners drives AIDS epidemics. If people did not have multiple sex partners, epidemics would not develop or, once developed, be sustained. Over a lifetime, it is the number of sexual partners [that matter]. Condom levels are found to be non-determining of HIV infection levels."

Hearst added: "we are raising a generation of young people in Africa that believe condoms will prevent HIV ... condoms are not 100 per cent effective, even when used properly. The most recent Meta-analysis came up with 80 per cent but even if it is 90 per cent, over time it's the question of when, not if. You don't want to give people a false sense of security and Abstinence and Behaviour are better in the long term."

Thailand saw incidence rates for HIV decrease after the government mandated 100 per cent condom use in brothels. According to Hearst and Dr. Rand Stoneburner (formerly of WHO, now independent adviser to USAID) proponents rarely look closer at the data, and in such instances behaviour change had much more to do with the decreased rates of transmission: "This is usually attributed to 100 per cent condom use, but visits to sex workers declined by 60 per cent. They did so out of fear and risk avoidance."

It is behaviour change advocated by the "A" and "B" approach that is additionally supported by data, such as in Uganda. According to Stoneburner, "... declines of HIV in Uganda are linked to behaviour change [and] include primary risk avoidance with a 65 per cent decline in causal sex." The Ugandan government, which promoted abstinence and faithfulness, helped bring about a 75 per cent decline in HIV prevalence among the 15-19 age group, 60 per cent in the 20-24, and a 54 per cent decline overall by 1998.