WaPo: Abstinence, Shown Working, 'Controversial' Anti-AIDS Tool
On the House floor, yesterday, Rep. Chris Smith (R-NJ) relayed this news, as reported by the Catholic News Agency (CNA):
"No generalized HIV epidemic has ever been rolled back by a prevention strategy primarily based on condoms.”
No major Old Media outlet has, as far as I can tell, reported Smith's relay of that powerful finding.
But the Washington Post's David Brown did find space in his coverage of the 2008 bill that would renew the President’s Emergency Plan for AIDS Relief (PEPFAR) to call abstinence initiatives "controversial."
Here is the relevant text from CNA (bolds are mine):
.... the congressman said recent reports showed the effectiveness of African HIV/AIDS prevention program based on promoting positive behavioral change.
“Five years after PEPFAR first began, the efficacy and importance of promoting abstinence and ‘be faithful’ initiatives have been demonstrated. The evidence is compelling,” Smith said.
PEPFAR, he said, relies on the ABC model, which stands for “Abstain, Be faithful, use Condoms.” Smith cited comments about PEPFAR from the U.S. State Department, USAID, and the Department of Health and Human Services that said the ABC model “is now recognized as the most effective strategy to prevent HIV in generalized epidemics… The legislation’s emphasis on ‘AB’ activities has been an important factor in the fundamental and needed shift in USG (Unitied States Global) prevention strategy from a primarily ‘C’ approach prior to PEPFAR to the balanced ABC strategy.”
Rep. Smith added that a “growing body of data” validates the behavioral changes encouraged by ABC programs. Data from Zimbabwe and Kenya “mirrors the earlier success of Uganda’s ABC approach to preventing HIV,” he noted.
….. Smith also referred to the September, 2007 testimony of Dr. Norman Hearst before the Foreign Affairs Committee. Hearst said, “Five years ago, I was commissioned by UNAIDS to conduct a technical review of how well condoms have worked for AIDS prevention in the developing world.” After he and his associates collected “mountains of data,” he said, “we then looked for evidence of public health impact for condoms in generalized epidemics. To our surprise, we couldn’t find any. No generalized HIV epidemic has ever been rolled back by a prevention strategy primarily based on condoms.”
One might think that those who hold out for a condoms-only, values-free approach to fighting AIDS might be in for heavy media criticism. Not according to WaPo's Brown, who wrote:
Although it contained controversial features, including a heavy emphasis on abstinence-oriented prevention strategies, the global AIDS program has been popular with lawmakers in both parties and has been praised around the world.
Jim Abrams of AP noted how what works (of course he didn't describe it in those terms) got shortchanged in the bill:
To advance the legislation, conservatives had to give up a provision in the 2003 act requiring that one-third of all HIV prevention funds be spent on abstinence programs. Instead it directs the administration to promote "balanced funding for prevention activities" in target countries.
So less than one-third of the money (in amounts that are ballooning out of control, as usual) is going to abstinence, the "A" element (see above) of what works. An unknown amount, but probably not much, will go to "being faithful," the "B" element, which also works. That leaves likely half or more -- billions and billions of dollars -- that will go to issuing condoms and encouraging their use, the "C" element, which hasn't ever worked when it's the primary strategy.
But David Brown, and the rest of Old Media, didn't find any of that "controversial."
Noted in briefer and revised form in the first item at this BizzyBlog post.