Fighting AIDS with abstinence

Bush's plan for AIDS relief in Africa: Promote condoms for "high-risk" groups, ignore transmission within marriage.

By Tracy Clark-Flory

Published July 10, 2007 11:00PM (EDT)

Here's an article by erstwhile Salonista Michelle Goldberg guaranteed to get you hot under the collar. She details the forehead-smacking failures of the Bush administration's AIDS initiative in Africa -- most ridiculously, its failure to adequately promote condom use. You see, the administration has a preferred prevention method. Say it with me now: Abstinence. It might be funny, if it weren't so incredibly deadly.

Condom use is encouraged only among "'high risk' groups like prostitutes and truck drivers," while the frequency of HIV transmission within marriage -- and a cultural expectation that men will have extramarital affairs -- is ignored. Goldberg quotes Beatrice Were, founder of the National Community of Women Living With HIV and AIDS: "We are expected to abstain when we are young girls and to be faithful when we are married to men who rape us, who are not necessarily faithful to us, who batter us." (I'm reminded of the study a few months back that found improving women's legal rights and cultural standing may very well be key in successfully fighting AIDS in Africa.)

Further enraging is that the President's Emergency Plan for AIDS Relief (PEPFAR) has actually been hailed as a "bright spot in an otherwise execrable presidency." U2's Bono even declared himself a "fan" of President Bush after Bush announced a plan to double spending to combat AIDS in Africa, allotting an additional $30 billion for PEPFAR. (Though Goldberg importantly points out: "Like most of the administration's financial figures, the numbers were misleading. The $30 billion was to continue funding PEPFAR for five more years essentially at current levels.")

Goldberg offers up this needed reality check: "For many toiling in the trenches of the pandemic, though, opinions about PEPFAR are far more ambivalent. It's a moral conundrum: how do you weigh lives saved by treatment against lives lost through policies that sabotage prevention?" If "sabotage" sounds like an overstatement, consider that one-third of HIV prevention funds go to "abstinence-only campaigns, often run by evangelical allies of the administration." Or, that if you actually look at the funds allocated to preventing the sexual transmission of AIDS (versus mother-to-child), two-thirds go to these abstinence programs.

As Goldberg plainly puts it: "That this policy is celebrated as Bush's greatest moral achievement shouldn't be understood as praise."

Tracy Clark-Flory

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