Saturday, 13 August 2011

Dreaming of an HIV-Free Generation?

The  chief of the UNICEF  field Office ‘A’, Enugu, recently reported that different surveys conducted between 2007 to 2010 showed that a higher HIV prevalence was witnessed among people less than 25 years old and that the epidemic has constituted serious hindrances to different aspects of human development. He attributed the high prevalence rate of the disease among this group of people to their capacity to engage in unprotected high risk sexual behaviours and drug/alcohol abuse.  It is troubling to note that the infection rate is still on the increase especially among the unmarried. I think it’s about time we had a rethink on the best way to achieve the goal of an HIV-free Generation - if such a feat is achievable.

Have we not done enough to check its spread? How come with the extensive availability of condoms, the young are still being infected? There are many routes of infection but obviously, the sexual route is the chief amongst this age group. Former Harvard University researcher Prof. Edward Green who rose to prominence in the AIDS controversy with his 2003 book, Rethinking AIDS Prevention recently authored a new book titled Broken Promises: How the AIDS Establishment has Betrayed the Developing World, which chronicles the continuing battle over how to prevent the spread of HIV/AIDS in sub-Saharan Africa.

In the book, Green and others compared the prevalence of HIV among 3 different groups: those who never used condoms, those who sometimes did, and those who always did. They found no association between HIV status and consistent condom use. Those who reported using a condom with every sex act were just as likely to have HIV as those who had never used one at all. They also found that inconsistent users had the same or greater HIV prevalence as non-users (pp 223-4). This is a frightening result given the vigor with which the condom campaign is carried out. Is this research authentic? Is he just pushing an agenda?

If we should go by these findings, then the slogan: “if you no fit hold body, use a condom”, offers false hopes and should be replaced with: “you no dey kampe with condom, hold body o!” In other words, condoms don’t give total protection from the virus. Otherwise, why is there still an increase in the prevalence of the infection among those less than 25 years when for some years now the condom campaign has been very popular? Practically every drug store sells condoms and a careful investigation may reveal that it is one of the highest selling commodities in these stores. The reasons for the increasing prevalence may be more complex but surely the false hope offered by the condom campaigners is a major contributor.

Prof. Green also documented how two radically different strategies have competed for funding and support. The first, by those who say that the most effective way to fight HIV spread is by behavioural changes such as sexual abstinence or faithfulness to one’s partner. This is a risk elimination strategy as the aim is to eventually eliminate the spread the disease. The second strategy is by those who say that there is need for change of sexual behavior as long as a condom is used every time. This is a risk reduction strategy since new infections would not be eliminated, only reduced; given the known failure rate of condoms.

In spite of mounting evidence of the failure of condom programs, the AIDS establishment ridicules as anti-scientific anyone who did not support their strategy. When Pope Benedict XVI was asked about AIDS in Africa, he said that “… if Africans do not help by responsible behaviour, the problem cannot be overcome by the distribution of prophylactics (condoms). On the contrary, they increase it.” For this he was roundly condemned, but according to Green, “He had summarized the best current research on AIDS prevention in Africa.” Prof. Green also said that, “In fact, [condom use] might actually contribute to higher levels of infection because of the phenomenon of risk compensation, whereby people take greater sexual risks because they feel safer than they really ought to because they are using condoms at least some of the time.”

HIV has infected some forty-six million people in Africa and eighteen million have died. Green believes this could have been brought under control two decades ago, had sexual behavioural change been employed, but because it was not we are now experiencing the greatest avoidable epidemic in history. While we still wait for a cure, it is clear that behavioural change is the best bet for achieving an HIV-free generation. Abstain or be faithful to your spouse and just maybe, just maybe we will achieve the goal of an HIV-free Generation someday.