A controversy erupted at a global AIDS conference on Monday over whether abstaining from sex or using condoms was more effective in preventing the disease. Ugandan president Yoweri Museveni brought the issue, which has set many AIDS activists at odds with Washington, into the open at the first full day of the AIDS conference by saying abstinence was the best way to stem the spread of the killer virus.
The remarks by Museveni, whose country is a rare success story in Africa's war on AIDS, were at odds with the position of health experts who back condoms as a frontline defense against the incurable disease. "I look at condoms as an improvisation, not a solution," Museveni told delegates on the second day of the 15th International AIDS Conference in Bangkok, Thailand. Instead, he called for "optimal relationships based on love and trust instead of institutionalized mistrust, which is what the condom is all about."
Museveni added fuel to a debate among AIDS experts over the best way to halt the spread of a disease that has killed 20 million people and infected 38 million. Uganda's "ABC" method (Abstinence, Being Faithful, and Condoms) is a model for the AIDS policies of the administration of U.S. president George W. Bush and which are under fire at the conference for advocating sexual abstinence to stem infection. This year's smaller U.S. delegation to the AIDS conference, which the United States says reflects a desire to cut costs, is seen partly as a sign of Washington's displeasure that its approach appears to have had little influence on the agenda.
U.S. congresswoman Barbara Lee, the only member of Congress to attend the weeklong meeting, accused the Bush administration of using ideology, not science, to dictate policy. She said the U.S. international AIDS initiative requires that one third of prevention funding go to "abstinence until marriage" programs. "In an age where 5 million people are newly infected each year and women and girls too often do not have the choice to abstain, an abstinence until marriage program is not only irresponsible, it's really inhumane," Lee said. "Abstaining from sex is oftentimes not a choice, and therefore their only hope in preventing HIV infection is the use of condoms."
Uganda's success in lowering HIV infection rates also has been twisted by the U.S. government in an effort to keep the support of religious conservatives, said Steven Sinding, director general of the International Planned Parenthood Federation. "It appears that this is naked pandering to an extremist constituency," Sinding said. "Millions of people around the world have been persuaded by the arguments of the U.S. government and religious right. Their actions represent a setback in bringing HIV/AIDS under control."
But Ted Green, a member of Bush's council on AIDS, said programs aimed at changing sexual behavior were not obtaining funding. He also questioned the focus on condoms. "If you are telling me that people can't stop AIDS unless they buy a product, I simply don't agree with that," he said.
Helene Gayle, head of AIDS programs for the Bill and Melinda Gates Foundation and former Centers for Disease Control and Prevention AIDS chief, said one approach was not better than the other. "The debate is more distracting than it needs to be, because we need to get on to the business of saving lives," she said. (Reuters)
