Dear Editor,
I am heartened that there are collaborations with the faith-based community and NGOs to combat HIV/AIDS in Guyana. However, the promotion of abstinence only prevention is not the perfect solution. The most successful approach in prevention is the ABC approach which has been proven to be effective in the United States and abroad. The ABC approach encompasses Abstinence, Be Faith-ful, and Condom. Abstinence alone is a lost battle.
An ACLU research in the United States (April 2005) stated: “there is no conclusive evidence that abstinence- only-until-marriage programs, which teach students to abstain from sex until marriage and generally only teach about contraceptive failure, reduce the rate of unintended pregnancy or sexually transmitted diseases (STDs). The research further indicated that many of these programs do not help teens delay having sex.” Yet the US federal government continues to fund well over half a billion dollars since 1997 (or $165 millions dollars annually) into abstinence only programmes.
On the contrary, evidence shows that “comprehensive sexuality education programs that provide information about abstinence and contraception can help delay the start of sexual activity in teenagers and increase condom use among sexually active teens.” Yet, here in the United States, there is no federally funded programme dedicated to supporting comprehensive sexuality education.
Abstinence is only a myth not science based.
Data shows that comprehensive sex education programmes that include information about risk reduction methods and condom efficacy and contraception are effective. There is no scientific evidence that supports abstinence only as an effective strategy for prevention. The promotion of abstinence only programmes is a representation of a particular ideology that attempts to advance that individuals should not engage in sexual activities unless or until they are in a heterosexual marriage instead of a science-based public health strategy. (AmfaR AIDS Research 2007)
Effective condom use.
There are numerous published reviews of the scientific literature that concluded that male latex condoms are 80 to 95 per cent effective in preventing HIV infection when used correctly and consistently. It also stated that the female polyurethane condom is 94 to 97 per cent effective under similar conditions. Condom use model is successful in HIV prevention.
According to the American Psychological Association (APA) press release of February 23, 2005 based on 15 years of research: “evidence shows that comprehensive sexuality education programs for youth that encourage abstinence, promote appropriate condom use, and teach sexual communication skills reduce HIV risk behavior and also delay the onset of sexual intercourse.” The APA Committee on Psychology and AIDS is charged with providing policy direction and oversight for activities related to HIV/AIDS. An area of concern by the committee is that while efforts are made to promote abstinence only programmes, there is little scientific evidence that these programmes work. The committee stated: “Those studies which report evidence in support of abstinence only and abstinence until marriage programs have very limited generalizability because they did not use appropriate comparison groups and they did not use the type of sampling strategies required to ensure minimum bias in the selection of research subjects.”
Therefore, abstinence only HIV prevention strategies will not be effective in stopping the spread of HIV infection. Human behaviour is the most difficult to change. Thus, condom use and effective sexuality education programmes cannot be overlooked. The ABC is the proven approach to HIV prevention. I agree with abstinence but not as the only strategy. What is the back up plan for high risk individuals who will not abstain? The only option of alternative prevention is effective condom use.
Yours faithfully,
Steve Hemraj
Editor’s note
Mr Hemraj is the Pro-gramme Manager – Carib-bean AIDS Access Initiative Program, Chair – New York City, Health and Human Services HIV Planning Council, and Chair – New York City Human Resourc-es Administration, HIV/ AIDS Service Administra-tion Advisory Board. All appointments are made by the Mayor of New York City.