Saturday, March 28, 2009

So What's the Problem?

Following on from my post yesterday about the bigoted attacks on the Pope this week.  I would like to publish today what the Pope actually said and which has got everyone so worked up:

I would say that this problem of AIDS cannot be overcome with advertising slogans. 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. The solution can only come through a twofold commitment: firstly, the humanization of sexuality, in other words a spiritual and human renewal bringing a new way of behaving towards one another; and secondly, true friendship, above all with those who are suffering, a readiness—even through personal sacrifice—to be present with those who suffer. And these are the factors that help and bring visible progress.

I simply do not know how anyone could really object to these comments.  The Pope himself would presumably be against condom use in all circumstances: we 
already know that, but that is not what he said to reporters.

Soon after the story broke, Kathryn Jean Lopez, editor of National Review Online, released an interview with Edward C. Green, director of the AIDS Prevention Research Project at the Harvard Center for Population and Development Studies. Here’s what he had to say:

We have found no consistent associations between condom use and lower HIV-infection rates, which, 25 years into the pandemic, we should be seeing if this intervention was working.

The pope is correct, or put it a better way, the best evidence we have supports the pope’s comments. He stresses that condoms have been proven to not be effective at the level of population. There is a consistent association shown by our best studies, including the US-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.

I also noticed that the pope said monogamy was the best single answer to African AIDS, rather than abstinence. The best and latest empirical evidence indeed shows that reduction in multiple and concurrent sexual partners is the most important single behavior change associated with reduction in HIV-infection rates (the other major factor is male circumcision).

So what's the problem with what the Pope said?  And why all the fuss?  Well, I would suggest that it's not because most of those reporting on this issue care about Africa.  It's hard to see who in the West cares about Africa at the moment.  Certainly the millenium goals have been quietly forgotten in the rush to help the American and European middle classes in danger of losing money in the present financial crisis.  A crisis brought on by their own greed!

To understand the irrational outcry against the Pope's comments, we need to appreciate that the west has seen a revolution in sexual behaviour that now means that the majority think thatpromiscuity is no big deal.  Indeed, on the contrary, it is celebrated daily in the newspapers and on TV.  Underpinning this, however, is the fervent hope that male condom wearing willensure that there are no nasty health consequences.  If condoms ultimately don't work in preventing sexually transmitted diseases, then the values and lifestyle that has been championed by many in the west would be under great threat.

The Pope's comments aren't a risk to the health of people in Africa, rather they are a challenge to the lifestyles of people in the west.

And that's the problem.

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