[TimG]

The following quote is from an article that can be found here.

Seems teaching abstinence might be more effective that distributing condoms.

Quote

Edward C. Green, director of the AIDS Prevention Research Project at the Harvard Center for Population and Development Studies, has said that the evidence confirms that the Pope is correct in his assessment that condom distribution exacerbates the problem of AIDS.

"The pope is correct," Green told National Review Online Wednesday, "or put it a better way, the best evidence we have supports the pope’s comments."

"There is," Green added, "a consistent association shown by our best studies, including the U.S.-funded ‘Demographic Health Surveys,’ between greater availability and use of condoms and higher (not lower) HIV-infection rates. This may be due in part to a phenomenon known as risk compensation, meaning that when one uses a risk-reduction ‘technology’ such as condoms, one often loses the benefit (reduction in risk) by ‘compensating’ or taking greater chances than one would take without the risk-reduction technology." ( see the full interview with Green here: http://article.nationalreview.com/?q=MTNlN...mMwNDM0OTEzMjQ… = )

The Harvard AIDS Project’s webpage on Green lists his book "Rethinking AIDS Prevention: Learning from Successes in Developing Countries ". It is stated that Green reveals, "The largely medical solutions funded by major donors have had little impact in Africa, the continent hardest hit by AIDS. Instead, relatively simple, low-cost behavioral change programs–stressing increased monogamy and delayed sexual activity for young people–have made the greatest headway in fighting or preventing the disease’s spread."

[Winstonm]

This may well be more of confusion of a correlation with a causation than genuine fact. One would need a much greater amount of accurate information before these types conclusions could be reached. For example, passing out condoms to aids victims who were also heroin addicts who shared the same needle would be unlikely to reduce exposure to the virus.

HIV is not a sexually-transmitted disease, but a bloodborn pathogen. The routes of invasion are not totally covered with a condom - unless it's the body-sized condom used by Leslie Nielson in "Police Squad".

[luke warm]

Winstonm, on Mar 29 2009, 12:50 PM, said:

This may well be more of confusion of a correlation with a causation than genuine fact. One would need a much greater amount of accurate information before these types conclusions could be reached. For example, passing out condoms to aids victims who were also heroin addicts who shared the same needle would be unlikely to reduce exposure to the virus.

HIV is not a sexually-transmitted disease, but a bloodborn pathogen. The routes of invasion are not totally covered with a condom - unless it's the body-sized condom used by Leslie Nielson in "Police Squad".

so what? the premise is that abstinence lowers the instances of hiv more than using condoms does... do you disagree with that?

[Winstonm]

luke warm, on Mar 29 2009, 04:22 PM, said:

Winstonm, on Mar 29 2009, 12:50 PM, said:

This may well be more of confusion of a correlation with a causation than genuine fact.  One would need a much greater amount of accurate information before these types conclusions could be reached.  For example, passing out condoms to aids victims who were also heroin addicts who shared the same needle would be unlikely to reduce exposure to the virus.

HIV is not a sexually-transmitted disease, but a bloodborn pathogen.  The routes of invasion are not totally covered with a condom - unless it's the body-sized condom used by Leslie Nielson in "Police Squad".  

so what? the premise is that abstinence lowers the instances of hiv more than using condoms does... do you disagree with that?

Jimmy, your wording of the statement is absolutely incorrect. The premise of the quote had nothing whatsoever to do with abstinence. What Green said was,

Quote

"There is," Green added, "a consistent association shown by our best studies, including the U.S.-funded ‘Demographic Health Surveys,’ between greater availability and use of condoms and higher (not lower) HIV-infection rates.

Quote

Instead, relatively simple, low-cost behavioral change programs–stressing increased monogamy and delayed sexual activity for young people–have made the greatest headway in fighting or preventing the disease’s spread

There is no mention anywhere of abstinence - the claim is that condom distribution exacerbates the AIDS problem; monogamy and delayed sexual activity reduce the risk.

Does monogamy reduce AIDS? Absolutely.
Does abstinence reduce AIDS? Of course.

All I challenged was the finding and methodolgy used, noting that AIDS is much more than a sexual problem. It actually has more in common with Hepatitis C than with pure sexually-transmitted diseases like gonorrhea.

There is simply no truth to the claim that given equal attempts a control group using condoms will have greater exposure than a control group using no condom.
The only thing this study may show is that condom use may exacerbate risk-taking behavior.

[kenberg]

Wait Jimmy. Before this all goes to hell, let me suggest a revised statement:Edit: I see that Winston types faster than I do

The claim is that abstinence programs are more effective than condom programs.

The effectiveness of abstinence and the effectiveness of abstinence programs are two very different things. To quote an old joke, the only problem with platonic relationships is that the woman gets pregnant.

Is it true that programs promoting abstinence are moer effective in lowering the AIDS/HIV rate than condom programs? I don't know. Someone who says it is so and claims to have solid evidence on his side should be given a hearing. He should also be questioned carefully.

Here would be a starter question, imo: To what extent do the results hinge on the social order? For example, if a young woman is given to a man, with her having very little say in the matter, and then he is free to go out and do as he pleases with whom he pleases, speaking of abstinence seems like a bad joke. On the other hand, I live near the District of Columbia which recently reported infection rates comparable to those in some very troubled countries. Women are presumably allowed to say no in DC. Men could show some judgment about whom they hop into bed with. A program aimed at convincing young people they might live a good deal longer if they exercised some judgment and restraint seems like it could have some merit.

In combating this menace, a good program is one that works. I don't care about its pedigree.

[Winstonm]

Quote

Wait Jimmy. Before this all goes to hell, let me suggest a revised statement

The only reason for it to go to hell is for one side to try to turn a health/science question into a morals/religion argument.

[hrothgar]

TimG, on Mar 29 2009, 07:50 PM, said:

The following quote is from an article that can be found here.

Seems teaching abstinence might be more effective that distributing condoms.

Quote

Edward C. Green, director of the AIDS Prevention Research Project at the Harvard Center for Population and Development Studies, has said that the evidence confirms that the Pope is correct in his assessment that condom distribution exacerbates the problem of AIDS.

"The pope is correct," Green told National Review Online Wednesday, "or put it a better way, the best evidence we have supports the pope’s comments."

"There is," Green added, "a consistent association shown by our best studies, including the U.S.-funded ‘Demographic Health Surveys,’ between greater availability and use of condoms and higher (not lower) HIV-infection rates. This may be due in part to a phenomenon known as risk compensation, meaning that when one uses a risk-reduction ‘technology’ such as condoms, one often loses the benefit (reduction in risk) by ‘compensating’ or taking greater chances than one would take without the risk-reduction technology." ( see the full interview with Green here: http://article.nationalreview.com/?q=MTNlN...mMwNDM0OTEzMjQ… = )

The Harvard AIDS Project’s webpage on Green lists his book "Rethinking AIDS Prevention: Learning from Successes in Developing Countries ". It is stated that Green reveals, "The largely medical solutions funded by major donors have had little impact in Africa, the continent hardest hit by AIDS. Instead, relatively simple, low-cost behavioral change programs–stressing increased monogamy and delayed sexual activity for young people–have made the greatest headway in fighting or preventing the disease’s spread."

The same author had an Op Ed in today's Washington Post

http://www.washingtonpost.com/wp-dyn/conte...9032702825.html

[Winstonm]

From the Op-Ed Richard provided.

Quote

10 AIDS experts concluded that "consistent condom use has not reached a sufficiently high level, even after many years of widespread and often aggressive promotion, to produce a measurable slowing of new infections in the generalized epidemics of Sub-Saharan Africa."

Quote

Let me quickly add that condom promotion has worked in countries such as Thailand and Cambodia, where most HIV is transmitted through commercial sex and where it has been possible to enforce a 100 percent condom use policy in brothels (but not outside of them).

It is convenient to isolate one aspect of the information and make it appear to support a presupposition - this is the Straussians' method. However, when you read the work in its entirity you find it in no way supports the isolated conclusion claimed.

And if you bother to read further you find that abstinence is not the only answer:

Quote

So what has worked in Africa? Strategies that break up these multiple and concurrent sexual networks -- or, in plain language, faithful mutual monogamy or at least reduction in numbers of partners, especially concurrent ones. "Closed" or faithful polygamy can work as well.

[TimG]

Winstonm, on Mar 29 2009, 06:03 PM, said:

Quote

Let me quickly add that condom promotion has worked in countries such as Thailand and Cambodia, where most HIV is transmitted through commercial sex and where it has been possible to enforce a 100 percent condom use policy in brothels (but not outside of them).

It is convenient to isolate one aspect of the information and make it appear to support a presupposition - this is the Straussians' method. However, when you read the work in its entirety you find it in no way supports the isolated conclusion claimed.

You cut your quote of the article off just before:

Quote

In theory, condom promotions ought to work everywhere. And intuitively, some condom use ought to be better than no use. But that's not what the research in Africa shows.

Which I found a bt amusing given your "it is convenient to isolate one aspect" comment.

[Lobowolf]

I don't believe that efficacy is the main consideration for most people on either side of this debate.

[Winstonm]

TimG, on Mar 29 2009, 09:09 PM, said:

Winstonm, on Mar 29 2009, 06:03 PM, said:

Quote

Let me quickly add that condom promotion has worked in countries such as Thailand and Cambodia, where most HIV is transmitted through commercial sex and where it has been possible to enforce a 100 percent condom use policy in brothels (but not outside of them).

It is convenient to isolate one aspect of the information and make it appear to support a presupposition - this is the Straussians' method. However, when you read the work in its entirety you find it in no way supports the isolated conclusion claimed.

You cut your quote of the article off just before:

Quote

In theory, condom promotions ought to work everywhere. And intuitively, some condom use ought to be better than no use. But that's not what the research in Africa shows.

Which I found a bt amusing given your "it is convenient to isolate one aspect" comment.

How quaint. I used the quotes only to show that your claims about poor results with condoms are specific only to Africa - not to try to prove a moral point by cherrypicking quotations.

I also notice you totally neglect the relevant part of the piece that discusses the main reason why condoms have not worked in Africa.

Quote

Another factor is that people seldom use condoms in steady relationships because doing so would imply a lack of trust. (And if condom use rates go up, it's possible we are seeing an increase of casual or commercial sex.) However, it's those ongoing relationships that drive Africa's worst epidemics. In these, most HIV infections are found in general populations, not in high-risk groups such as sex workers, gay men or persons who inject drugs. And in significant proportions of African populations, people have two or more regular sex partners who overlap in time.

Well, what a surprise. The people aren't using the darn things in the relationships that are most likely (in Africa) to spread the virus.

I do not disagree that abstinence is a superior method to prevent the spread of the virus. I don't believe anyone has ever claimed that condom use was foolproof. I still question the results that condom use actually increases the incidence - perhaps condom availability could raise the incidence of sexual behavior enough to make a difference, but not the actual use of condoms versus non-use. That makes no sense.

[Gerben42]

Quote

"The pope is correct," Green told National Review Online Wednesday, "or put it a better way, the best evidence we have supports the pope’s comments."

No he's not. The pope should come down from his pedestal. This is like Marie Antoinette saying that the people should just eat cake. It is grossly irresponsible and it is very unfortunate that no legal steps can be taken against the pope about this.

Sex is part of human nature and it is time that the Catholic church accepts reality for once. The real solution is not abstinence but education in combination with condoms.

I tried to formulate this as friendly as I could, this discussion makes me mad as hell because it really means that the bigwigs in Rome are for a large part responsible for not avoiding suffering thousands if not millions of people.

Problems like these are not for one man to solve, and should be approached with an open mind, not with a personal agenda.

[luke warm]

kenberg, on Mar 29 2009, 05:36 PM, said:

Wait Jimmy. Before this all goes to hell, let me suggest a revised statement:Edit: I see that Winston types faster than I do

The claim is that abstinence programs are more effective than condom programs.

ok, sorry... abstinence programs... the use of 'abstinence programs' instead of 'abstinence' would have been better... still, winston makes a leap when he says this has nothing to do with abstinence... he also makes a leap when he tries to force a dichotomy between health and religion

Winstonm, on Mar 29 2009, 09:37 PM, said:

How quaint.  I used the quotes only to show that your claims about poor results with condoms are specific only to Africa - not to try to prove a moral point by cherrypicking quotations.

that's his point, you did cherry pick quotations in making your point that he was cherry picking quotations... i'm not sure 'quaint' is the right word

[helene_t]

Lobowolf, on Mar 30 2009, 03:13 AM, said:

I don't believe that efficacy is the main consideration for most people on either side of this debate.

I dunno. The article Richard linked is very cynic in saying that condoms have become a symbol of women's emancipation, but of course there is some truth to that. Not sure how much truth. I have some colleagues who are in AIDS prevention and as far as I can tell they don't have a strong condom bias.

I could be wrong. Also, it could very well be that social workers, nurses, physicians and politicians are more biased in this respect than statisticians are.

Also, I can easily imagine that even if a researcher does not have a condom bias himself, he is influenced by the suspicion that his sponsors and reviewers are. Or he thinks it would be difficult to get condom revisionism published because peers will think he must have an agenda.

[TimG]

Winstonm, on Mar 29 2009, 09:37 PM, said:

How quaint. I used the quotes only to show that your claims about poor results with condoms are specific only to Africa.

Not my claims. The claims made in the article which I posted a portion of and a link to. The portion which I quoted included "have had little impact in Africa". But, that is just coincidental, I included the quote so that people could get an idea of what the linked article was about -- I dislike when people post links to articles with no explanation. That's also why I wrote "Seems teaching abstinence might be more effective that distributing condoms." Though I guess I would have been better off if I had also included "Africa" in that.

Anyway, I found the link to the article on a friend's facebook page. Someone had commented that "this information is good to have for school programs" which is what really grabbed my attention (in a head shaking, disbelieving sort of way).

[hrothgar]

I spent a bit of time trying to read up on this topic yesterday...

Here's my best guess about what's going on:

1. Nearly everyone seems to agree that condoms are an effective way to prevent the transmission of veneral diseases provided that they are used as intended.

2. Even if used as intended, condoms aren't 100% effective. However, they are still extremely effective.

3. Statistical studies conducted in Asia demonstrate that condoms have been effective in stopping the spread of AIDS.

4. Some statistical studies conducted in Africa fail to demonstrate that condoms have been effective in stopping the spread of AIDS.

5. One hypothesis is that the difference between Africa and Asia has to do with specific behaviour patterns. In Asia, the spread of AIDS is largely linked to the sex trades. Brothel owners and sex workers are in a strong position to require condom usage. In Africa, things are much less centralized. Lots of individuals engage in high risk behaviour. They are often unwilling to use condoms because they would (tacitly) be admitting that they might be at risk.

6. Some studies show that Uganda has been effective in slowing down the spread of AIDS by focusing their messaging around sexual monogomy, abstinence, etc.

It's really hard to tell what's, what... Especially because a lot of the individuals participating in AIDS policy seem to have external agendas.

From my perspective, the "big" piece that is missing is discussion regarding combining messaging and providing condoms.

Could a messaging / advertizing program like Uganda adopted be successful in increasing condom usage in Africa?

Alternatively, do concerted advertizing campaigns that make negative claims about the effectiveness of condoms have an impact on people's willingness to use them?

[Lobowolf]

Gerben42, on Mar 30 2009, 02:23 AM, said:

it is very unfortunate that no legal steps can be taken against the pope about this.

I'd just like to go on the record and take the other side of this one. I think it's fortunate when legal steps aren't taken against people for expressing their views.

[barmar]

Abstinence almost certainly reduces the spread of AIDS. The problem with abstinence programs is that they don't result in much abstinence.

I'm sure that any studies of the effectiveness of various techniques can pretty easily control for other transmission vectors like needle sharing and tainted blood transfusions.

There's still the correlation versus causation factor, though. For instance, last week a report came out saying that eating too much red mean increases the chance of death. But is it possible that people who are prone to short life also have an increased craving for red meat?

[Al_U_Card]

Winstonm, on Mar 29 2009, 12:50 PM, said:

This may well be more of confusion of a correlation with a causation than genuine fact. One would need a much greater amount of accurate information before these types conclusions could be reached. For example, passing out condoms to aids victims who were also heroin addicts who shared the same needle would be unlikely to reduce exposure to the virus.

HIV is not a sexually-transmitted disease, but a bloodborn pathogen. The routes of invasion are not totally covered with a condom - unless it's the body-sized condom used by Leslie Nielson in "Police Squad".

Seems to me that the retrovirus is much smaller than the pore size of a latex condom....therefore kind of like hoping that throwing a pea against a "Frost" wire fence will keep a pea from going thru...

retrovirus = . pore size =

No contact = no infection

Condoms = more contact = more infections

No condoms = a little more contact = a little more infection

[helene_t]

Al_U_Card, on Mar 30 2009, 05:48 PM, said:

Seems to me that the retrovirus is much smaller than the pore size of a latex condom....

Possibly true, but irrelevant. The virus is dissolved in sperm plasma and as long as the condom holds back the sperm plasma, it holds back virtually all of the virus.