Abstinence a universal failure

Letters, Normal

THE Business Coalition Against HIV/AIDS is disturbed to note The National’s editorial titled “Condoms promote promiscuity” (Feb 5).
This opinion piece is not only based on ignorance but it is completely contradictory to the significant body of research in HIV prevention, family planning and sexual and reproductive health.
First and foremost, research conducted globally has consistently failed to demonstrate a link between the promotion of condoms and increased sexual activity (or in the writer’s judgmental language “promiscuity”).
Condom promotion is one of many critical interventions that when used in combination, provide a comprehensive response to preventing the transmission of HIV.
The promotion of abstinence is now regarded as a universal failure in the context of HIV prevention.
Perhaps the most recent and greatest example of the failure of abstinence-only campaigns was the rapid increase in teenage pregnancies in the US during the George W Bush’s years when abstinence was the only government-sanctioned and funded intervention for sexual and reproductive health.
The editorial also espouses the value of monogamy within marriages.
The problem with relying on promoting faithfulness to one sexual partner is that it assumes women always have the power and ability to make those choices.
Sadly, in countries like ours, many women do not have that choice.
PNG has one of the highest rates of sexually transmitted infections in the world. Clearly, this did not happen in an environment of “devilish” condom promotion.
To down play the significance of condoms or place doubt in their usage in order to promote family values is both disingenuous and dangerous.
Family values are upheld by the current HIV policy framework.
However, your line of reasoning assumes that all families are basically cohesive units without family violence, infidelity and disharmony.
While we are sure that the majority of families basically are cohesive, many are not.
Are we to ignore this group on the basis that they do not fit the model family as espoused?
Should those that cannot meet your high moral standards be denied some form of protection from unwanted pregnancy and/or sexual transmitted diseases of which HIV is only one?
Thankfully, we have a national policy framework in PNG that has been endorsed by the Government and is based on research findings.
The national policy for HIV prevention highlights “the dynamics of HIV transmission in PNG are influenced by a great diversity of sexual cultures, with different values, norms, beliefs and practices”.
It also highlights “the potential for sexual transmission of HIV is heightened by early sexual debut, often in situations of coercion and abuse; multiple and concurrent sexual partnerships, including polygamy, extramarital sexual partnerships and inter-generational sex; the exchange of sex for cash, goods, and services; low and inconsistent condom use; and high levels of sexual violence and rape”.
These are, unfortunately, the facts.
Sure condoms have failed to prevent HIV transmission, but not for the reasons they state.
Condoms have failed as a prevention strategy because the level of consistent and correct condom use among the population is too low to have had any impact on reversing the growing HIV epidemic in our country.
The only area we are seeing a rise in consistent condom use is among sex workers.
This has been due to significant efforts by many people, including sex workers themselves, to take a responsible public health approach to preventing HIV transmission.
The impact of national efforts to the HIV response can only be felt when all parties involved understand that a broader prevention strategy that tries to address all aspects of human existence including poverty alleviation, family violence, gender inequality, housing and sanitation, before any blame is laid on any one aspect of HIV prevention such as the promotion of condoms.

Port Moresby