# Aids Prevention. Whats wrong with ABC? **URL:** \ **Category:** Great Debates\ **Created:** [August 20, 2006, 4:25am UTC](https://boards.straightdope.com/t/aids-prevention-whats-wrong-with-abc/369421 "2006-08-20T04:25:10Z")\ **Posts on this page:** 20\ **Page:** 1
**Author:** ![The\_Flying\_Dutchman](https://avatars.discourse-cdn.com/v4/letter/t/9fc348/32.png) [@The\_Flying\_Dutchman](https://boards.straightdope.com/u/The_Flying_Dutchman)\ **Post date:** [August 20, 2006, 4:25am UTC](https://boards.straightdope.com/t/aids-prevention-whats-wrong-with-abc/369421/1 "2006-08-20T04:25:10Z")
I wasn’t impressed with the tone of the International AIDS Conference recently held in Toronto. I’m fairly certain positive things were accomplished that weren’t reported, but what I did see and hear would indicate a lot of groups and individuals had agendas that were riding on the coat tails of the AIDS and were more interested in bashing governments, especially the Bush Administration. The [booing](http://www.lifesite.net/ldn/2006/aug/06081403.html) that Gates got for mentioning the ABC program got my particular attention. > [@](#): > > The general flavour of the conference, however, was made abundantly clear during Gates’ opening remarks, where the thousands of delegates violently booed one of the rare mentions of abstinence and sexual fidelity as possible solutions to AIDS, and enthusiastically cheered for latex, pharmaceuticals, and increasing acceptance of prostitution and hard drug use. > > In his opening remarks to the conference Gates briefly mentioned the controversial ABC (Abstinence, Be faithful and Condoms) program, the program of HIV/Aids prevention that is pushed internationally by the Bush Administration, and which has been employed with unprecedented success by the Ugandan government. “This approach,” said Gates, “has saved many lives, and **we should expand it.”** Poor Bill. He decides to backtrack > [@](#): > > Unperturbed, Gates, to sudden and swelling cheers, then continued to highlight the “limits” of such a program, and criticized abstinence and faithfulness as ultimately ineffective and unrealistic methods of prevention. What the fuck? Then there is Bill [Clinton](http://i.abcnews.com/Politics/wireStory?id=2317094) > [@](#): > > Clinton joined Microsoft co-founder Bill Gates in praising President George W. Bush’s President’s Emergency Program for AIDS Relief, saying it has done more good than harm. > > Such support for the conservative Bush government was unexpected at the 16th International Conference on AIDS, a meeting held every two years where activists join researchers, funding agencies and aid groups to discuss the pandemic and, usually, denounce most governments for doing too little. > > Clinton, whose foundation negotiates cheaper prices for drugs and HIV tests in developing nations, said PEPFAR has done a lot of good, despite a requirement that 33 percent of prevention funding be spent on abstinence-only programs. > > “If you take out the 30 percent of the money that has to be spent on that — the other 70 percent is still a whopping amount of money and more money in federal aid than I think anybody else is getting,” Clinton told a plenary session of the conference. > > That said, Clinton joined the majority of experts who say abstinence-only programs do not work. Better, he said, are programs that include abstinence counseling as part of a range of options. More good than harm. What the hell? Where’s the harm? And lets be clear. The amount of abstinence education aid is not 33% of the [15 billion dollars](http://www.heritage.org/Research/Africa/BG1692.cfm) the US government has allocated for AIDs. Its only 1 billion total. And where’s the evidence that abstinence programs do not work? They are practiced in Uganda and fundamentally credited with Uganda’s relative success in the AIDS [turnaround](http://www.avert.org/aidsuganda.htm).And where the hell are abstinence _only_ programs offered? Lets not confuse an abstinence only program with an abstinence education program. > [@](#): > > Why was Uganda’s response so effective? > The approach used in Uganda has been named the ABC approach - firstly, encouraging sexual Abstinence until marriage; secondly, advising those who are sexually active to Be faithful to a single partner or to reduce their number of partners; and finally, especially if you have more than one sexual partner, always use a Condom. A number of factors helped to encourage people to take up these strategies. So why the anger against against a such successful approach? Why does Uganda’s experience not impress the delegates at the conference? ---
**Author:** ![saoirse](https://avatars.discourse-cdn.com/v4/letter/s/5daacb/32.png) [@saoirse](https://boards.straightdope.com/u/saoirse)\ **Post date:** [August 20, 2006, 5:05am UTC](https://boards.straightdope.com/t/aids-prevention-whats-wrong-with-abc/369421/2 "2006-08-20T05:05:01Z")
I can’t speak for Uganda, although every partisan will claim that any improvement is due to his own pet project, so I doubt the validity of the analysis right off the bat. However, I do know that abstinence programs in the US have failed miserably. Teenage girls who took an abstinence pledge did not delay having sex by any appreciable amount of time, and when thye did have sex they more liekly to not use condoms or birth control. ---
**Author:** ![Miller](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/miller/32/481_2.png) [@Miller](https://boards.straightdope.com/u/Miller)\ **Post date:** [August 20, 2006, 5:14am UTC](https://boards.straightdope.com/t/aids-prevention-whats-wrong-with-abc/369421/3 "2006-08-20T05:14:13Z")
I’m guessing their argument is that, while the ABC program worked in Uganda, it was only the condoms that did any good, and the money spent on trying to promote abstinence and monogamy was wasted. ---
**Author:** ![tashabot](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/tashabot/32/6250_2.png) [@tashabot](https://boards.straightdope.com/u/tashabot)\ **Post date:** [August 20, 2006, 5:18am UTC](https://boards.straightdope.com/t/aids-prevention-whats-wrong-with-abc/369421/4 "2006-08-20T05:18:51Z")
I can’t remember where I read it but somewhere it did say that abstinence education didn’t work as well as people would have hoped, and that it was condoms that seem to prevent most HIV transmission. However, I don’t understand why people are booing fidelity; as far as I can tell, it’s the safest thing to do nowadays. But hey, whatever floats your boat. You ain’t sleepin’ with ME, though. :eek: ~Tasha ---
**Author:** ![sinjin](https://avatars.discourse-cdn.com/v4/letter/s/ebca7d/32.png) [@sinjin](https://boards.straightdope.com/u/sinjin)\ **Post date:** [August 20, 2006, 5:55am UTC](https://boards.straightdope.com/t/aids-prevention-whats-wrong-with-abc/369421/5 "2006-08-20T05:55:18Z")
Wait, what’s this “Abstinence, Be Faithful, Condoms” thing? I thought it was Abstinence Before Condoms. Am I confused or did I miss a memo? ---
**Author:** ![Terrifel](https://avatars.discourse-cdn.com/v4/letter/t/c68b51/32.png) [@Terrifel](https://boards.straightdope.com/u/Terrifel)\ **Post date:** [August 20, 2006, 11:25am UTC](https://boards.straightdope.com/t/aids-prevention-whats-wrong-with-abc/369421/6 "2006-08-20T11:25:12Z")
> [@The Flying Dutchman](#): > > And lets be clear. The amount of abstinence education aid is not 33% of the [15 billion dollars](http://www.heritage.org/Research/Africa/BG1692.cfm) the US government has allocated for AIDs. Its only 1 billion total. That doesn’t appear to be what Clinton claimed, though; rather, he pointed out that 33% of **prevention funding** is set aside for abstinence-only programs. Since only 20% of the original 15 billion is allocated for prevention funding, 1 billion would work out to 33.3% – close enough for a politician striving for accuracy without wanting to sound like Mr. Spock about it. More subjectively, LifeSite’s account of delegates cheering in support of “increasing acceptance of prostitution and hard drug use” seems to be a fairly egregious mischaracterization, at least from the evidence presented in the article itself. The account only cites Bill Gates’ speech, in which he was cheered for addressing the limits of abstinence-only programs: > [@](#): > > In the course of the speech the United States Government’s anti-prostitution and anti-drug stance also came under fire for allegedly endangering sex-workers and drug addicts. This hardly seems like a ringing endorsement of prostitution and hard drug use. Frankly if Bill Gates had publically expressed support for hookers and heroin, I would have expected it to get a lot more airplay, liberal media or no. ---
**Author:** ![irishgirl](https://avatars.discourse-cdn.com/v4/letter/i/8edcca/32.png) [@irishgirl](https://boards.straightdope.com/u/irishgirl)\ **Post date:** [August 20, 2006, 5:08pm UTC](https://boards.straightdope.com/t/aids-prevention-whats-wrong-with-abc/369421/7 "2006-08-20T17:08:01Z")
ABC works when both partners in a relationship have equal standing, and where both partners are listening to the message and taking it to heart. A fairly significant proportion of people in the world living with HIV/AIDs are women, who have had only one sexual partner (their husband). Many of these women do not have the power to prevent their husbands from seeking extra-martial affairs. They do not have the power to insist their husband uses protection with his other partners. They do not have the power to insist he uses condoms when he has sex with them. Sometimes they do not even have the power to abstain from sex if he refuses to use a condom- marital rape is considered an oxymoron in many parts of the world where HIV/AIDS is prevalent. In many societies, the only option open to a woman who divorces her husband is a life of prostitution and begging on the streets. That is, if she has the power to divorce her husband at all! Of what use is ABC to these women? They are faithful, they can’t abstain, and their husbands won’t use condoms! ---
**Author:** ![JillGat](https://avatars.discourse-cdn.com/v4/letter/j/9fc29f/32.png) [@JillGat](https://boards.straightdope.com/u/JillGat)\ **Post date:** [August 20, 2006, 5:21pm UTC](https://boards.straightdope.com/t/aids-prevention-whats-wrong-with-abc/369421/8 "2006-08-20T17:21:03Z")
Jonathan Mann, when he was head of the AIDS program for WHO, said the biggest HIV risk behavior for women in Africa is getting married. Gates, too, supports the idea that until women gain power in relationships, this isn’t going to change. ---
**Author:** ![The\_Flying\_Dutchman](https://avatars.discourse-cdn.com/v4/letter/t/9fc348/32.png) [@The\_Flying\_Dutchman](https://boards.straightdope.com/u/The_Flying_Dutchman)\ **Post date:** [August 20, 2006, 7:59pm UTC](https://boards.straightdope.com/t/aids-prevention-whats-wrong-with-abc/369421/9 "2006-08-20T19:59:26Z")
> [@irishgirl](#): > > Of what use is ABC to these women? > They are faithful, they can’t abstain, and their husbands won’t use condoms! If their husbands won’t use condoms, isn’t it better to educate their husbands into the values of fidelity? after all these husbands are subject to the same disease. ---
**Author:** ![Der\_Trihs](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/der_trihs/32/233_2.png) [@Der\_Trihs](https://boards.straightdope.com/u/Der_Trihs)\ **Post date:** [August 20, 2006, 8:10pm UTC](https://boards.straightdope.com/t/aids-prevention-whats-wrong-with-abc/369421/10 "2006-08-20T20:10:47Z")
> [@tashabot](#): > > However, I don’t understand why people are booing fidelity; as far as I can tell, it’s the safest thing to do nowadays. Considering that quite a few Third World women have gotten AIDs from rape, it reeks of blaming the victim. Also, as **irishgirl** said, it does you no good to be faithful if your husband ( or wife for that matter ) sleeps around. Condoms work no matter what your partner is doing when you aren’t looking. ---
**Author:** ![The\_Flying\_Dutchman](https://avatars.discourse-cdn.com/v4/letter/t/9fc348/32.png) [@The\_Flying\_Dutchman](https://boards.straightdope.com/u/The_Flying_Dutchman)\ **Post date:** [August 20, 2006, 8:14pm UTC](https://boards.straightdope.com/t/aids-prevention-whats-wrong-with-abc/369421/11 "2006-08-20T20:14:35Z")
To follow up. What if the husband is now educated and willing to use condoms? Does that solve the problem ? Is there any guarantee that he will use condoms with every hooker he comes across? In the devoloped world, what percentage of men use hookers? Isn’t it possible to develop an education program discouraging indiscrimanate sex by men in Africa ? What if the wife wants to have children ? Most people do want to have children you know. How do you get around condoms for that? (not intended to discourage the use of condoms) In my opinion the prevailing morality in western societies (and I hate to say it but Muslim societies as well) is clear indication that abstinence, but more important fidelity, is the best defence against AIDS. ---
**Author:** ![JillGat](https://avatars.discourse-cdn.com/v4/letter/j/9fc29f/32.png) [@JillGat](https://boards.straightdope.com/u/JillGat)\ **Post date:** [August 20, 2006, 8:34pm UTC](https://boards.straightdope.com/t/aids-prevention-whats-wrong-with-abc/369421/12 "2006-08-20T20:34:36Z")
> [@The Flying Dutchman](#): > > If their husbands won’t use condoms, isn’t it better to educate their husbands into the values of fidelity? after all these husbands are subject to the same disease. Better than what? That’s the idea of the campaign, yes. ---
**Author:** ![Lissa](https://avatars.discourse-cdn.com/v4/letter/l/85f322/32.png) [@Lissa](https://boards.straightdope.com/u/Lissa)\ **Post date:** [August 20, 2006, 8:42pm UTC](https://boards.straightdope.com/t/aids-prevention-whats-wrong-with-abc/369421/13 "2006-08-20T20:42:29Z")
> [@The Flying Dutchman](#): > > And where’s the evidence that abstinence programs do not work? They don’t work in the United States. Why would they work better elsewhere? [This](http://dir.salon.com/story/news/feature/2004/02/24/abstinence/index.html) article states: > [@](#): > > Yet studies also show that when teenagers from abstinence-only programs do have sex, they’re less likely than others to use protection. > > \ > > The evidence on abstinence-only programs from elsewhere hasn’t been much more promising. Last year, the Minnesota Department of Health evaluated the state’s five-year, $5 million abstinence-only program and found that it hadn’t reduced sexual activity among teenagers at all. Instead, over a year, the rates of sexual activity among students taking the abstinence course doubled, from 5.8 percent to 12.4 percent, which corresponded to the rate of sexual activity among teens statewide. The evaluators found a “lack of fit between the program and kids who face complex problems in their lives and are most at risk for sexual activity.” Worse, teens who take abstinence-only sex ed are less likely to use protection when they do have sex: > [@](#): > > According to a 2001 study published in the American Journal of Sociology, students who’d signed public “virginity pledges,” a key component of many abstinence-only programs, had sex an average of a year and a half later than their peers. Yet when they did have sex, they were a third less likely to use contraceptives. ---
**Author:** ![The\_Flying\_Dutchman](https://avatars.discourse-cdn.com/v4/letter/t/9fc348/32.png) [@The\_Flying\_Dutchman](https://boards.straightdope.com/u/The_Flying_Dutchman)\ **Post date:** [August 20, 2006, 8:45pm UTC](https://boards.straightdope.com/t/aids-prevention-whats-wrong-with-abc/369421/14 "2006-08-20T20:45:52Z")
> [@JillGat](#): > > Better than what? Better than not promoting fidelity. I refer you to the words of Bill Gates > [@](#): > > Unperturbed, Gates, to sudden and swelling cheers, then continued to highlight the “limits” of such a program, and criticized abstinence and **faithfulness** as ultimately ineffective and unrealistic methods of prevention. (bolding mine) ---
**Author:** ![Miller](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/miller/32/481_2.png) [@Miller](https://boards.straightdope.com/u/Miller)\ **Post date:** [August 20, 2006, 8:48pm UTC](https://boards.straightdope.com/t/aids-prevention-whats-wrong-with-abc/369421/15 "2006-08-20T20:48:18Z")
> [@The Flying Dutchman](#): > > Isn’t it possible to develop an education program discouraging indiscrimanate sex by men in Africa ? One that’s effective? Probably not. Attempts at encouraging abstinence just don’t work. They’ve been tried over and over, and their failure has been consistent. People just don’t listen when you tell them not to have sex. For whatever reason, though, some of them listen when you tell them to use a condom. Which is probably why the crowd at the conference were booing mention of abstinence. At this point, abstinence is only being mentioned because of political pressure. Leaders representing socially conservative constituencies press for abstinence education because it suits their ideological biases, and they are unwilling to admit that reality does not reflect those biases. If AIDS research could be de-politicized, no one at that conference would be talking about abstinence education, any more than a symposium on evolution would waste time talking about Lamarckism. It’s been discredited, and continuing to focus on it now is a drain of resources that could be better spent on programs that are effective. ---
**Author:** ![irishgirl](https://avatars.discourse-cdn.com/v4/letter/i/8edcca/32.png) [@irishgirl](https://boards.straightdope.com/u/irishgirl)\ **Post date:** [August 20, 2006, 8:51pm UTC](https://boards.straightdope.com/t/aids-prevention-whats-wrong-with-abc/369421/16 "2006-08-20T20:51:46Z")
There is educating men about the values of fidelity, and there is overturning the cultural norm in which masculinity is, to some extent, defined by the number of sexual partners or wives one has, and the number of children one fathers. There are cultures where a man isn’t just permitted or allowed to have extra-marital affairs, or to use prostitutes, he is considered useless and less than a “real man” if he doesn’t. Some cultures see condoms as inherently wrong because they’re a form of contraception, or the invention of white people, or simply because they might reduce physical sensitivity for the male partner. Changing all of that is going to need more than a handy alphabetic slogan, some free condoms and pretending that telling people “stick to one partner for the whole of your life” is actually going to work for everyone. It’s certainly not the way the majority of people here live, is it? ---
**Author:** ![Der\_Trihs](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/der_trihs/32/233_2.png) [@Der\_Trihs](https://boards.straightdope.com/u/Der_Trihs)\ **Post date:** [August 20, 2006, 8:55pm UTC](https://boards.straightdope.com/t/aids-prevention-whats-wrong-with-abc/369421/17 "2006-08-20T20:55:00Z")
> [@The Flying Dutchman](#): > > Better than not promoting fidelity. As I said, promoting fidelity or relying on it is foolish. Churches and governments have tried that for thousands of years, with little to no effect. The only effect making marital fidelity into an ideal or law has is to make people work harder to hide infidelity; it doesn’t _stop_ them from sleeping around. Promoting fidelity as a method of AIDS prevention will just produce false security in those foolish enough to trust their husband or wife that way. And no, I’m not saying that _all_ spouses sleep around, just that you can’t trust them not to do so, especially with your life. The trustworthy ones look just like the untrustworthy, after all. ---
**Author:** ![Der\_Trihs](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/der_trihs/32/233_2.png) [@Der\_Trihs](https://boards.straightdope.com/u/Der_Trihs)\ **Post date:** [August 20, 2006, 8:58pm UTC](https://boards.straightdope.com/t/aids-prevention-whats-wrong-with-abc/369421/18 "2006-08-20T20:58:32Z")
> [@irishgirl](#): > > There is educating men about the values of fidelity, and there is overturning the cultural norm in which masculinity is, to some extent, defined by the number of sexual partners or wives one has, and the number of children one fathers. IMHO the only differences between men and women on this is that men are more open about it and have more lovers, not that they are more faithful. After all, who do you think those men are having sex with, each other ? ---
**Author:** ![irishgirl](https://avatars.discourse-cdn.com/v4/letter/i/8edcca/32.png) [@irishgirl](https://boards.straightdope.com/u/irishgirl)\ **Post date:** [August 20, 2006, 9:06pm UTC](https://boards.straightdope.com/t/aids-prevention-whats-wrong-with-abc/369421/19 "2006-08-20T21:06:04Z")
I agree with you, but in the parts of the world where HIV/AIDS are most prevalent, extra-marital affairs are usually between the husband and an unmarried, widowed or divorced woman or prostitute. Not always, but usually. I’m not saying that married women aren’t having affairs, just that the consequences they face are harsh (being divorced, thrown out of their home or village, forbidden to see their children) and so proportionally fewer of them would be expected to look outside of their marriages. ---
**Author:** ![The\_Flying\_Dutchman](https://avatars.discourse-cdn.com/v4/letter/t/9fc348/32.png) [@The\_Flying\_Dutchman](https://boards.straightdope.com/u/The_Flying_Dutchman)\ **Post date:** [August 20, 2006, 9:10pm UTC](https://boards.straightdope.com/t/aids-prevention-whats-wrong-with-abc/369421/20 "2006-08-20T21:10:56Z")
> [@Lissa](#): > > They don’t work in the United States. Why would they work better elsewhere? I would stronly suspect that the incidence of AIDS in America is substatially lower than in Africa. It appears to me despite all the rock videos, CDs and Holywood characterizations that by and large most American teenagers delay actual sexual intercourse to well into their late teens or at least well beyond the general African experience. I also strongly suspect that Americans take infidelity much more seriously as a whole than African males. The value of fidelity is built into American culture and it is even predominant from what I’ver read in the highly “liberal” slant of this message board. If there are failures I would suspect the mechanics of the program and that the targets are “hard core”. I have no interest in abstinance _only_ programs. I am interested in the promotion of abstinence outside of committed relationships as an option and the promotion of fidelity especially. The correlation of limiting sexual intercourse to AIDS reduction only makes common sense and precedent exists in much of the rest of the world. [Next page](https://boards.straightdope.com/t/aids-prevention-whats-wrong-with-abc/369421.md?page=2)