Condoms vs. Abstinence

Population Services International (PSI), a USAID-funded group, uses aggressive and ubiquitous advertising campaigns to flood the media with a pro-condom message. These safe sex campaigns involve, to use PSIs own martial language, a constant barrage of radio spots and films shown on television, in cinema halls, and on [PSIs] fleet of mobile film vans all extolling the perfect protection afforded by condom usage.(2)

Over the course of the nineties, USAID shipped approximately 5 billion condoms abroad.(3) Billions of others came from the UN Population Fund, the UKs Overseas Development Agency, and other providers. Yet, despite this flood of condoms into the developing world, the rate of HIV/AIDS infection continued to grow at startling rates. The number of victims increased one thousand-fold, from just over 40 thousand in 1990 to over 40 million in 2000. Why is this?

One answer may be suggested by a review of the scientific evidence on condom effectiveness conducted by the National Institutes of Health (NIH).(4) Citing a study by Davis and Weller, NIH postulated that condoms, if consistently and properly used, provide an 85% reduction in HIV/AIDS transmission risk.(5) While no one would deny that this reduction in risk is significant, it is far from being the perfect protection promised by the safe sex propaganda funded by USAID. Even paved with condoms, the road to promiscuity still leads to death.

The failure of condoms to provide perfect protection against HIV/AIDS is also suggested by studies of condom use for the prevention of pregnancy. Approximately 3% of couples who reported using condoms consistently and correctly (considered perfect use) are estimated to experience an unintended pregnancy during the first year of use.(6) If sperm can find their way around the latex barrier, then so, presumably, can the AIDS virus.

To further complicate matters, the presumed protection resulting from using a condom may lead to behavioral changes that completely negate the protection. For example, an individual who believes that consistent and correct use of condoms provides near-absolute protection against HIV/AIDS may engage in recklessly promiscuous behavior that they would otherwise avoid. Why? Because they have been led to believe that, by practicing safe sex, they are immune from contracting the disease. In this way, the rate of HIV/AIDS transmission may not be reduced at all by the safe sex message, but actually increase over time.

A recent article in The Lancet, a premier British medical journal, suggested that a condom-based approach, by creating a false sense of security on the part of users, had not only failed to stop the spread of AIDS, but had actually exacerbated the problem. The authors drew a parallel with the seat belt law, which was projected to dramatically decrease the number of traffic fatalities. Instead, the number of deaths remained roughly the same, as drivers took risks they previously would have avoided because they felt safer. (7)

Perhaps this is one of the reasons why, despite massive shipments of condoms overseas, the rate of HIV/AIDS infections continues to grow.

Only one African nation has successfully combated the scourge of AIDS. Uganda owes its success in combating AIDS, most health experts agree, chiefly to abstinence. "Uganda's outstanding success really has American heads turning," said Dr. Milton Amayun, World Vision's HIV/AIDS international program representative. "Experts in the U.S. are starting to see the value of teaching people to limit their sexual relationships within the context of marriage."(8)

Abstinence, not condoms, is the key to stopping the AIDS epidemic in Africa.

Endnotes

1. There is new evidence suggesting that medical transmission is responsible for most HIV/AIDS in Africa. See PRI Weekly Briefing, Are Africans Promiscuous Unto Death? 5:12, 24 April 2003.
2. PSI Profile: Social Marketing and communications for health, 2-sided flyer on Bringing Mass Media to Rural Populations through Mobile Video Vans, November 1994.
3. USAID, USAID Highlights, 6:4, 1989; USAID, Population, Health and Nutrition Projects Database; note: the volume of USAID condoms shipped overseas is likely smaller than that of the UN Population Fund, which boasts of being the largest international supplier of condoms. Also cited in PRI Review, 13:1, JanuaryFebruary 2003, p. 4.
4. Scientific Evidence on Condom Effectiveness for Sexually Transmitted Disease (STD) Prevention, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Department of Health and Human Services, 20 July 2001.
5. Davis, K.R. and Weller, S. C., The Effectiveness of Condoms in Reducing Heterosexual Transmission of HIV, Family Planning Perspectives 1999, 31(6):272-279.
6. Trussell, J., Contraceptive Efficacy, In Hatcher, R.A., Et al., (Eds.) Contraceptive Technology, 1998. Chapter 31:779-844, 17th Revised Ed., Ardent Media, New York, NY. Cited in Scientific Evidence on Condom Effectiveness for Sexually Transmitted Disease (STD) Prevention, p. 10.
7. John Richens, et al., Condoms and seat belts: the parallels and the lessons, The Lancet, Vol. 355, 29 January 2000.
8. Uganda's "ABC" Approach to AIDS Proven Effective