Is Pope Benedict being criticized unfairly for his comments about HIV and condoms?

This is hard for a liberal like me to admit, but yes, it's unfair because in fact, the best evidence we have supports his comments - at least his major comments, the ones I have seen.

What does the evidence show about the effectiveness of condom-use strategies in reducing HIV infection rates among large-scale populations?

It will be easiest if we confine our discussion to Africa, because that's where the pope is, and that is what he was talking about. There's no evidence at all that condoms have worked as a public health intervention intended to reduce HIV infections at the "level of population." This is a bit difficult to understand. It may well make sense for an individual to use condoms every time, or as often as possible, and he may well decrease his chances of catching HIV. But we are talking about programs, large efforts that either work or fail at the level of countries, or, as we say in public health, the level of population. Major articles published in Science, The Lancet, British Medical Journal, and even Studies in Family Planning have reported this finding since 2004. I first wrote about putting emphasis on fidelity instead of condoms in Africa in 1988.

Is there any country worldwide (Brazil or Thailand, for example) that has emphasized condoms where a reduction in HIV infections has been verified and sustained?

In countries where HIV is largely concentrated among prostitutes and their clients, such as Thailand and Cambodia, there seems to have been success in promoting the so-called 100 percent condom policy in brothels. Most analysts credit the decline of HIV infection rates there to this policy and its implementation (of course, they were saying that about Uganda as well), but I agree that this probably has been the major factor explaining prevalence decline in those two countries. However, condom use is not especially high for prostitutes and their clients who are not based in brothels. And another factor in both countries is surely that there was a significant decline in the proportion of men going to prostitutes of any sort, and there was even a big decline in the proportion of men having extramarital sex in the years before we first saw infections decrease in Thailand.

Is there any country in Africa with a high HIV infection rate that has implemented new programs and seen infection rates fall? If so, what strategies are being followed?

I'm glad you asked this. We are seeing HIV decline in eight or nine African countries. In every case, there's been a decrease in the proportion of men and women reporting multiple sexual partners. Ironically, in the first country where we saw this, Uganda, HIV prevalence decline stopped in about 2004, and infection rates appear to be rising again. This appears to be in part because emphasis on interventions that promote monogamy and fidelity has weakened significantly, and earlier behavior changes have eroded. There has been a steady increase in the very behavior that once accounted for rates declining - namely, having multiple and concurrent sex partners. There is a widespread belief that somehow Uganda had fewer condoms. In fact, foreign donors have persuaded Uganda to put even more emphasis on condoms.

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Prominent Ugandan AIDS Activist Thanks Pope for Opposition to Condoms
Says, "when you look at many of these so called AIDS activists, they are simply in it for the money"

By Hilary White

ROME, March 20, 2009 (LifeSiteNews.com) - A prominent Ugandan AIDS activist says that those who are attacking the pope for his stand against the use of condoms in the fight against the disease have "no credibility." In an e-mail sent to LifeSiteNews.com today, Ssempa thanked Pope Benedict for saying that condoms can exacerbate the problem of HIV/AIDS.

After twenty years as an AIDS prevention activist in Uganda, Martin Ssempa says he has concluded that the real culprit in the spread of the disease "is sexual promiscuity driven by immorality of the heart."

Ssempa, a pastor and government consultant on AIDS prevention, told LifeSiteNews.com, "It is a complete lie for many to say that Uganda has succeeded by a major condom campaign."

Earlier this week, at the start of his trip to Africa, Pope Benedict told reporters that the solution to the AIDS problem is "a spiritual and human renewal bringing a new way of behaving towards one another." Condemnation by the world's media, and the international AIDS and homosexualist organisations, exploded when the pope said, "If the soul is lacking, if Africans do not help one another, the scourge cannot be resolved by distributing condoms; quite the contrary, we risk worsening the problem."

Ssempa told LifeSiteNews.com today that he believes the pope was right. Ssempa has long maintained that this kind of attack on the pope and the Catholic Church's position, that occurs regularly in the press, stems from the hatred and fear in the "AIDS industry" of traditional morality in general and of sexual continence in particular.

"Here in Uganda when AIDS came we did not think it was caused by lack of condoms. No it was the presence of promiscuity. What the Pope is saying is true. It however makes those who are determined to live in a life of promiscuity feel spotlighted," Ssempa said.

Martin Ssempa has spent nearly two decades on the frontline of Uganda's highly successful AIDS prevention program that focuses on encouraging sexual abstinence and fidelity in marriage. "Our successful policy," he said, "always put abstinence and being faithful ahead of any medical products such as condoms and testing." He questioned the failure of most media outlets to investigate the motives of the international AIDS organisations, saying, "Many of these writers and naysayers, are actually shills in the service of big pharma.

"Many are entangled in lucrative deals to distribute condoms and the more condoms they push out the more money they get. How come no one has ever made a comment on how much money is being made by big pharma out of the whole condom, testing and drug business?

"In fact when you look at many of these so called AIDS activists, they are simply in it for the money," he added.

Uganda's population is mainly Christian, and the message, supported by government-sponsored promotion, that men and women should not engage in extra-marital sex dramatically reduced Uganda's AIDS rate over the last couple decades. Ssempa and other local AIDS activists have frequently decried the interference of US and Europe-based international organizations who reject abstinence and fidelity principles in favor of condoms. This, they say only encourages promiscuity and the spread of the deadly disease. Since the intervention of the international AIDS groups, with their emphasis on condoms and downplaying of abstinence, Uganda's AIDS rate has begun, according to local experts, to "tick back up."

Ssempa co-authored Uganda's successful policy with Dr. Edward Green of Harvard University's Center for Population and Development Studies. Dr. Green told the National Review Online this week that Pope Benedict's assertion that condoms only make the AIDS crisis worse is backed by the research.

"There is," Green said, "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."

Ssempa warned that there is no security in using condoms to protect against the AIDS virus. "Those who believe that they can put all their trust in getting a perfect condom in Africa are totally out of sync with the realities of Africa.

"In 2004 August more than 40 million condoms of the Engabu brand were found to be defective and were recalled to be destroyed. This was after a huge public outcry on the condom failures which may have exposed many people to HIV/AIDS in the false hope of security from these latex from China."

Ssempa said that there needs to be a complete rethinking of the reliance on condoms. Citing Dr. Green's work at Harvard, he said, "We must ask the tough question, why does the nations in Africa with the highest condoms correspond with the highest HIV/AIDS? These include Botswana and South Africa who have the first and highest condoms per male, yet their numbers of HIV/AIDS are also the same.

"They are in the top three spots of the nations with the highest HIV/AIDS. On the other hand nations with lower condoms per male per year correspond with lower HIV/AIDS."

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