Edward Green: “Pope was right on AIDS in Africa”

Speaking in Rimini, Italy, public health researcher Edward Green said that Pope Benedict was right when he said that different sexual behavior, not condoms, is needed to stop AIDS in Africa.

Green, writing in March in the Washington Post, made it clear that his position is scientific, based in data, rather than ideological.  He does support access to condoms, and names specific situations in which emphasis on condom use has been associated with a reduction in the spread of AIDS.

The research identifies two reasons why condom-promotion programs have not had an effect on the spread of AIDS in Africa.

The first is a psychological process called “risk compensation.”  When people think that they are made safer by using condoms at least some of the time, they engage in risky behavior more often. The result is equal or higher exposure to AIDS than prior to the use of condoms.

The second is related to cultural patterns within Africa.   Insisting on condom use with a regular partner implies a lack of trust, so it rarely occurs. Yet in many African populations, people have two or more regular sexual partners who overlap in time, sometimes in formally polygamous marriages, but other times without any marriage, or with partners outside of the ostensibly monogamous marriage.  Green reported in March 2009, “In Botswana, which has one of the world’s highest HIV rates, 43 percent of men and 17 percent of women surveyed had two or more regular sex partners in the previous year.”

This pattern creates “a giant, invisible web of relationships through which HIV/AIDS spreads. A study in Malawi showed that even though the average number of sexual partners was only slightly over two, fully two-thirds of this population was interconnected through such networks of overlapping, ongoing relationships.”

Within these cultural patterns, emphasis on condom use is likely to increase the risk compensation pattern of behavior, and – overall – serve to increase, rather than decrease, the incidence of AIDS.

In the African setting, programs that focus on ABC – Abstaining from sex when possible (because, due to the web of relationships, even one’s regular partner may become a source of infection), Be Faithful to a single partner or, in polygamous marriages, within a closed circle, and C – as a last resort, use a Condom – have had better results.

In his Washington Post article, Green also commented on the straight-jacket that he and other HIV/AIDS researchers face when they question the efficacy of condom-oriented AIDS programs – which have become an ideology as much as a policy.  He said,

“We liberals who work in the fields of global HIV/AIDS and family planning take terrible professional risks if we side with the pope on a divisive topic such as this. The condom has become a symbol of freedom and — along with contraception — female emancipation, so those who question condom orthodoxy are accused of being against these causes.”

Green, who supports condom programs in other cultures, contrary to Catholic teaching, is nonetheless getting a fuller hearing from Catholic audiences than the data and research he reports are able to obtain in the secular press.

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