I posted extensively before about how Uganda�s approach to HIV & AIDS education � a combination of abstinence, monogamy, and condom education � had a remarkable effect on reducing reporting incidences of HIV in the populace. I also posted information that pointed out that claims to massive reductions in new HIV infections in Uganda were premature at best and politically motivated at worst. There is a hell of a lot more work that needs to be done, both epidemiologically and educationally, before any claim to victory over new infections in Africa can be claimed. However, there is ample evidence that a multi-faceted approach involving a multitude of community and governmental agencies, can have a profound impact on preventing and treating the disease.

I�ve also pointed out that there is no evidence � above anecdotal � that abstinence-only education works as a full, preventative measure to control HIV/STD exposure. What evidence there is for it�s effectiveness shows that it works with only a very narrow cohort of young people, under a very narrow set of circumstances and only for a relatively short (18 month) period of time. Further, it has the disastrous consequence that when people actually do have sex, they are more likely to engage in unprotected and unsafe activities well above those rates of those who received safer sex education.

The article that most of the mentioned sites are passing off as defitive is anything but. It�s actually chalked through with so much faulty information that ignorance just doesn�t seem to be a possible excuse. The author tires to say that the Uganda AIDS Commission formal policy makes no mention of condoms as a sanctioned tool in that countries fight against HIV (��Condom use was not listed among the commission's recommendations��) and then links to a page that doesn�t mention condoms. The author eaves out the fact that the page linked to isn�t the �Official Recommendations� page but rather a FAQ page, where a graph on condom usage fails to load. Clicking over to the priorities page shows that safer sex education is under the first priority for it�s national policy. Clicking on other pages of the site turns up similar examples in the stated goal of encouraging condom use among options.

The �Dr. Edward Green� that is mentioned in the report as the �expert� who spoke on how condoms don�t work, while a credentialed HIV resource at Harvard, wasn�t speaking as a result of any studies he conducted, but rather at a �CHRISTIAN CONNECTIONS FOR INTERNATIONAL HEALTH MESSAGE� conference about his own views on the subject. The �paper� that he presented wasn�t from a peer-reviewed study, but rather his own thoughts � which is rather meaningless as definitive research goes.

Two other points about Dr. Green�s paper. He writes:

Of course, it is very difficult to attribute behavioral change in Uganda, Jamaica or anywhere to any one, or combination of, interventions. It is very hard to control for confounding variables. And few studies have looked specifically at the impact of FBOs..

That�s a far cry from the whole �abstinence is the secret� message so many have quoted him. Perhaps most telling of all, he says:

It is reasonably well-established that consistent condom use protects against HIV transmission, therefore condom use should be promoted.

The big doctor that everyone has been citing as their source on the �no condoms� campaign is asking for further research into the effectiveness of religious groups in preventing HIV/AIDS and has not been saying �condoms don�t work.�

Funny if the effects of such misstatements weren�t so vile.

As for NRO�s own bit about how safe sex information is to blame for new HIV infections among young gay men, the most charitable thing I can say is that the author displays a great capacity for arraying words on a page and none for actually having them make any sense.

Ralph J. DiClemente, PhD, at Emory University published an article in the Southern Medical Journal
Volume 95, Number 6 2002 (�Protease Inhibitor Combination Therapy and Decreased Condom Use�) that did point out that gay men who were being treated for HIV infection with HAART therapy were more likely to not use condoms than any other group he surveyed. It was the success of treatment that actually caused this decline:

The influences that encourage and reinforce high-risk sexual behavior are not well understood among persons treated with protease inhibitors. For instance, in an ongoing study of HIV-infected women, the best predictor of STDs, an objective marker of high-risk sexual intercourse, was the perception that unprotected sexual intercourse did not confer any additional risk for adverse consequences.[22] Thus, inaccurate knowledge, and perceptions of low susceptibility to and severity of adverse outcomes, may militate against the adoption and maintenance of protective behavior such as condom use during sexual intercourse. More in-depth studies examining individuals' motivations for engaging in high-risk sex will provide valuable information critical for the design of patient education and sexual risk-reduction interventions.

It�s the fact that people aren�t dying in the same graphic and visible ways that, it seems, have caused many people to go back to unsafe sex � not safe sex education in general.

�.extensive print and electronic media coverage may have inadvertently raised treatment expectations beyond the empirical evidence. Consequently, HIV-infected persons' perceptions of the severity of HIV infection and their susceptibility to other adverse sequelae associated with high-risk sexual intercourse may be diminished and their willingness to engage in high-risk sexual behavior may increase.

We humans are notorious for disregarding the advice of the angels of our better natures to stumble back into old, and bad, patterns of behavior once the most visible examples of the negative behavior either aren�t visible or unknown.

Quick thought example, one I�ve used before: How many times, exactly do you brush and floss your teeth, every day? Once? Twice? Three times? Do you brush and floss, or do you just brush? When you are tired after a long day, do you go and stumble into bed and worry about your teeth in the morning? On lazy weekends, after sleeping late, do you still scrub those teeth three times a day, or let one or more sessions slide? If you are like most people, you don�t brush your teeth three times a day, every day, rain or shine � let alone floss. As often as you do do it, it�s mostly likely you do it because you�ve been hit by continual messages about brushing�s value, about how it prevents tooth decay and gum disease.

Outside of a root canal, getting a cavity removed isn�t that painful � the novocaine deadens the mouth and blocks the pain. Most of the discomfort comes from that whirring drill and having to spit every minute or so. That though, may even be a thing of the past, what with laser cavity removal . Given how difficult it is to get an educated first world populace to consistently and continually brush their teeth -- let a lone -- people express surprise and bewilderment at condom use and HIV prevention.

There is no movement to abolish bike helmet, seat belt, flu shot, yearly physical, bran eating, saving for retirement, or any other possible positive outcome education because people don�t do it all the time. We actually count ourselves lucky that we reached the people we did, desire to do more to reach those we haven�t and accept the fact that people, no matter how smart or dumb, even with the best information, continue to do the most boneheaded things imaginable. Why don�t we throw the whole education process out for any of these, in light of an impact that isn�t 100%? Because we know education works, even if people don�t use that education.

There is a wall here folks. AIDS kills. The ways to prevent AIDS from doing that is not to be exposed to it. Not getting exposed to it means:
1. Not having sex, [Abstinence]
2. Not having sex in any way or with through any activity that exchanges body fluids [Safer Sex]
3. Having sex that exchanges bodily fluids only with one other person who also only has sex with you [Monogamy]
4. Using a condom anytime you have sex with anyone where there is any activity occurs involving body fluids. [Condom use and Safer Sex]

People only know about this through education, education, and education. Research has shown that education can and does save lives. Attempts and efforts to limit or deny that education in favor of an incomplete and faulty message (abstinence only education) is exactly the same thing as trying to run through a brick wall by using the power of mind over matter: it�s doomed to failure.

To continue to spread this gospel of ignorance, because of the dictates of pride, arrogance and a profound lack of compassion for the needs and suffering of others, is not just criminal, not just reprehensible but fundamentally and inexcusably immoral. Ultimately, those who further this lie are not motivated by the noblest of sentiments, but rather acting from the darkest and blackest realms of malice known to the Human soul.

There is simply no excuse.