The Need for a Real Prevention Revolution
Posted on | May 12, 2011 by Lauren Funk |
Last week UNAIDS hosted a Commission on AIDS Prevention in Cape Town, South Africa. As part of the programming, Treatment Action Campaign (TAC) partnered with UNAIDS in sponsoring a “condom march” through the streets of Khayelitsha, Cape Town’s largest and fastest-growing suburb.
In a press release, UNAIDS explained that the condom march & distribution was intended to “scale-up the use of condoms in communities most severely affected by HIV,” and celebrate condoms as a barrier against the spread of the virus. “Here in Khayelitsha, Treatment Action Coalition is empowering people living with HIV into leaders of the HIV prevention revolution,” said UNAIDS Executive Director Michel Sidibé.
The secretary-general of TAC explained their approach to HIV prevention, saying
“Our view at TAC is that condoms are by far the most effective tool to prevent HIV…We take condoms to people in their houses,” she explains. “We also consistently teach others about the correct use of condoms…”
A march participant explained his own approach to scaling up HIV prevention:
“Keep on mentioning condoms all the time, and let them be seen and be available everywhere,” he advises. “When I say they must be available, I don’t just mean physically, I mean mentally too. You have to have ‘condoms of the mind’ to really change behavior.”
However, showering Khayelitsha with condoms is not the most effective approach to HIV prevention- a fact that has been confirmed in a number of studies, including those conducted by UNAIDS itself. Condom distribution may actually have a negative effect on generalized epidemics. Though still few in number, the voices of scientist and practitioners who are willing to acknowledge the harmful results of their rate of failure, the inconsistency of their use, and their tendency to foster disinhibition and increase risky behaviors, are increasing.
What does work in HIV prevention? Behavioral change. Interventions based on abstinence before marriage and fidelity in marriage have been proven to be the most effective (often, the only effective) response to generalized HIV epidemics. It would indeed be a revolution of sorts if the international community were to widely acknowledge this fact. It is a shame that UNAIDS is not only failing to show leadership in this area, but is actually promoting prevention methods that are ambivalent at best and harmful at worst. UNAIDS and the international community must reconsider the condom, and thus conventional wisdom, on how to stop the spread of HIV if they are truly seeking a “prevention revolution.”
