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Strategies for Preventing Hiv Debated At AIDS Conference

BY Admin  July 12, 2004 at 1:21 PM EDT

Uganda’s approach to preventing new HIV infections, known as “ABC,” stresses “Abstinence, Being faithful and Condoms” — in that order — and is backed by the Bush administration.

Some AIDS experts are instead pushing for a greater emphasis on condoms and clean syringes for intravenous drug users. Their philosophy is known as CNN, or Condoms, Needles, Negotiating Skills.

An epidemiologist tracking Asia’s emerging epidemics told conference delegates that the world’s most populous continent faces HIV problems largely driven by prostitution, and that condoms are the best way to keep the virus from spreading.

“I disagree with (Museveni). … Condoms are greatly shortchanged in Africa as a prevention method,” said Tim Brown, of the Hawaii-based think tank East West Center. “If you increase condom use by 50 percent, I guarantee you that HIV will go down by 50 percent.”

Museveni said loving relationships based on trust are crucial in the HIV-fighting campaign, and that “the principle of condoms is not the ultimate solution.”

Uganda’s infection rate dropped from more than 30 percent in the early 1990s to about 6 percent of the country’s 25 million people last year.

In a stance that sets Museveni apart from some of his supporters, he also argued the concept of marriage should be flexible and staying with someone when a relationship turns sour may lead to infidelity that causes both partners to become infected with HIV.

“Ideological monogamy is also part of the problem,” he said.

The Bush administration has come under fire at the conference for focusing on sexual abstinence to stem infection.

In a June speech on AIDS in Philadelphia, President Bush touted Uganda’s ABC approach as a “practical, balanced and moral message.”

During a conference session Monday titled “CNN v. ABC,” Steven Sinding of the International Planned Parenthood Federation said “condoms will remain key preventive tools for many, many years to come.”

He said condoms should be seen as the key element of a comprehensive strategy that should include abstinence. The U.S. policy of emphasizing abstinence is a “serious setback to the AIDS control effort,” he argued.

Ted Green, a member of Bush’s council on AIDS, questioned the emphasis on condoms in an interview with Reuters. “If you are telling me that people can’t stop AIDS unless they buy a product. I simply don’t agree with that,” he told the news agency.

Some at the conference urged those attending to stop arguing over the two approaches. Helene Gayle, head of AIDS programs for the Bill and Melinda Gates Foundation, said one strategy was not better than the other.

“The debate is more distracting than it needs to be because we need to get on to the business of saving lives.”