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Harvard researcher: Abstinence & faithfulness more effective against AIDS, but public health officials emphasize condoms

NASHVILLE, Tenn. (BP)–A deadly virus is sweeping through nations, killing millions, and if people don’t want to catch it, they must consider changing their sexual behavior, a Harvard researcher told Baptist Press.

The public health establishment, meanwhile, has failed to recognize the obvious in assessing AIDS prevention methods because it fears endorsing a perceived religious conservatism related to abstinence and faithfulness, Edward C. Green, a research scientist at Harvard University and author of “Rethinking AIDS Prevention,” said.

“It’s so insane that [abstinence and faithfulness] has not been part of the advice from the beginning,” Green said.

The U.S. Agency for International Development shelved Green’s 2003 report on AIDS prevention methods in Africa and hired a condom advocate to conduct another study instead. Green had concluded that the “ABC” method — Abstinence, Being faithful in marriage and Condoms only for high-risk populations — was most effective in the dramatic reduction of AIDS cases in Uganda.

“Some people say ABC is not new, it has been around and we’ve always had that. Maybe it has been around as an unofficial policy, but no one has put money or programs into the promotion of abstinence or fidelity outside of religious groups. … [N]ot just Christianity but Islam and other religions have always promoted abstinence and faithfulness, and many of them are quietly working with almost no money at the grassroots and quietly promoting these behaviors.”

Despite the lack of funding, Green said there is a trend in Africa toward more abstinence and fidelity. The Harvard researcher said he found that if you ask people in those countries why they’re choosing those methods, it’s typically because some religious group told them they have to do it or they’ll die. And such blatant truth-telling is stemming the tide of the AIDS epidemic in some African nations.

Green first focused on the facts in Uganda in 1993 and was stunned to see infection rates were falling because of something other than condoms.

“Nobody believed that the rates were coming down and nobody believed that it had anything to do with abstinence and faithfulness,” he said. “I said to USAID in a report that’s published in my book, ‘Ah! Look, they’re doing something different, and it’s working. My recommendation: Put more resources into abstinence and faithfulness.’ That was 12 years ago.”

Green added, “My father, the late Marshall Green, was the first U.S. Ambassador for Population Affairs at the State Department. That means promotion of contraception, primarily. When I told him in 1993 about what was going on in Uganda, he immediately said, ‘Why, this is amazing! We need to mobilize the religious groups!'”

Faith-based organizations, Green also noted, have “a really important role to play, and they’ve been sidelined. Almost no faith-based groups working in AIDS prevention have been funded by major donors, major organizations that fund AIDS programs.

“Faith-based organizations have been working with orphans and working with the sick and the dying and the bereaved and so forth, taking care of spiritual needs, taking care of economic needs,” Green said. “But they haven’t been funded to work in AIDS prevention. That’s crazy because they have an extremely important role to play.”

Referring to abstinence and faithfulness, Green said, “We have in our possession a social vaccine,” reflecting a point made by fellow AIDS researcher Rand Stoneburner. “The biomedical vaccines we talk about for AIDS have been 10 years away for 20 years. They’re still far away, and no one is expecting such a vaccine to be more than about 35 or 40 percent effective when and if we get one. But as Stoneburner has been saying, we already have a social vaccine promoting partner reductions, fidelity, monogamy, abstinence.”

Green said he agrees with Stoneburner’s assessment that USAID’s refusal to accept the overwhelming success of the ABC method — rather than a greater emphasis on condoms — is a human rights abuse.

“I think that’s putting it a bit harshly because I don’t think most people that are promoting condoms — because I used to be a condom promoter myself — would think of themselves as abusing human rights,” Green said, adding that he agrees “there’s been a lot of bias, a lot of refusal on the part of medical journals to publish evidence that contradicts what everyone thinks.”

“So when you think that millions of lives have probably been lost because we’ve refused to look at the lessons from Uganda and some of the other countries of the world that are in my book, maybe in the future historians may look back and say that was a human rights abuse to not recognize or publish [that evidence],” Green said. “We talk about USAID, but no one published it. The United Nations, World Health Organization, medical journals have been rejecting articles that contradict the consensus-based paradigm.”

Norman Hearst, a medical doctor and researcher at the University of California in San Francisco, was asked to do a review of condom effectiveness for UNAIDS, the joint United Nations program on HIV/AIDS, in 2003.

“Norman thought pretty much like everyone else until he did that review. He did the review and said, lo and behold, there’s no evidence that in a generalized epidemic that condoms have made a difference,” Green said.

For many years, Green noted, the tobacco industry avoided acknowledging a connection between smoking and lung cancer. But if an organization were given $15 billion to address lung cancer globally — just as President Bush has allotted $15 billion for AIDS prevention in Third World countries — those charged with the task would likely start with changing smoking behavior, Green said.

“You would advise young people not to start smoking and [say to others], ‘If you already smoke, consider giving it up or at least have fewer cigarettes per day,'” he said. “But for the last 20-plus years we have not been able to say that about sexual behavior. We haven’t been able to talk about sexual behavior in that way, like, ‘If you’re young, don’t start until you’re married,’ and, ‘If you’ve already started, stick to one partner. Don’t have dozens or scores or hundreds of partners.'”

Programs have not been funded by the United States that promote such changes in sexual behavior to save lives, Green said, although the Ugandan government has taken such an approach and seen tremendous results.

“I think one of the things that has kept the public health establishment from recognizing the obvious is, ‘This sounds like religious conservatism, so we can’t endorse it,'” he told BP.

Green said the ABC method is something that can work anywhere to reduce the spread of the deadly HIV virus that causes AIDS.

“In any infectious disease, you want to limit your number of contacts, whether it’s measles or hepatitis or HIV or syphilis or anything else,” he said. “And how do you limit your contacts when it comes to something that’s sexually transmitted but with fidelity and abstinence? So that could work in the gay community in America, it could work anywhere.”

Doctors in New York City announced in February that they had encountered a stronger HIV strain that is resistant to nearly all drugs and leads to the rapid onset of AIDS. The strain was found in a man who had tested negative for HIV in 2003 and likely had contracted the virus last October, according to a report in The New York Times. By January, the virus was not responding to the various anti-retroviral drugs used to treat HIV, and he was showing symptoms of AIDS.

Initial reports indicated the man had sex with hundreds of partners, possibly in one of the sex marathons that have become popular among homosexual men, yielding 10 to 20 partners per night. The marathons involve mixing drugs like crystal methamphetamine and Viagra, and too often, condoms are not used.

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  • Erin Curry