Tom Colborne delves into the thorny issues of abstinence and condom use and reveals why TackleAfrica have signed up to promoting a new HIV prevention mantra. Have your say…
Abstain. Be faithful. Condomise. Yoweri Museveni, one of the first African leaders to acknowledge and react to the growing HIV crisis, built his prevention response on these pillars. And, at first, it worked – Uganda’s HIV prevalence dropped from an estimated 20% in the mid1990s to around 5% about 10 years later. But now the rates have started to grow again, and those involved in holistic HIV responses are moving away from the ABC prevention message.
Why?
First there was the phenomenon of what has been called ‘A, B and the silent C’ with many organisations promoting total abstinence from sex as the only way to be truly safe. Which is more or less correct of course (leaving aside mother to child, needle or blood transmission) – but then any policy which involves telling 800 million people not to have sex is going to have a job on its hands. Road accidents kill more people across Africa than anything else behind AIDS-related illnesses – but would you build a road safety campaign based on telling people not to use vehicles or cross roads?
One of the very few mercies of HIV compared to other lethal viruses is that it’s actually quite difficult to catch – you essentially have to find somebody living with the virus and then either gestate in their womb or have unprotected sex with them; even then transmission is far from inevitable. But two of the things that every person on this planet is more or less guaranteed to do are gestate in a womb and have unprotected sex. And when up to 40% of your community has HIV, finding someone to do those things with isn’t that difficult either.
This is not to say that the A and the B are the wrong messages. Delaying first sexual experience has been proven to lower vulnerability to HIV (as well as STIs and unwanted pregnancy), and fidelity from both partners in an HIV-negative relationship is a sensible strategy. But without the C the dogma risks becoming idealistic rather than implementable, evangelistic rather than pragmatic, aspirational rather than attainable.
As people have learned more about the HIV epidemic and how it impacts upon and is amplified by every imaginable stream of human behaviour at individual, family, community, state and global level, other challenges to the ABC message have emerged.
What if you are a young woman in an African country highly affected by poverty, living within a male dominated culture and lacking the education, skills, confidence, rights or basic resources to make decisions? You might want to Abstain, but you may not have a choice. You might Be faithful but what if your partner has other wives or girlfriends? How do you negotiate Condom use if your husband or partner may beat you or throw you out on the street for even suggesting it?
TackleAfrica now promote Christian Aids’ SAVE message, which provides a far more rounded approach to HIV prevention strategies. Our training and education resources promote all of these messages, as well as abstinence and fidelity where possible and the importance of gender equality, joint decision making and respect for women.
Safer Practises
Available medication
Voluntary testing and counselling
Empowerment
Unfortunately HIV prevention is NOT as easy as ABC. One Chicago-based campaign promoting female condom use borrows a more up to date lyrical message from Beyonce’s Single Ladies – ‘if you like it then you shoulda put a ring on it’.
Download this to learn more about SAVE, contact us, or have your say below.
Tom Colborne, 04/11/2010. One Game Saves Lives
TackleAfrica promote condom use with all of our beneficiaries and with all coaches that we train as we know that discussing correct and consistent condom use does not increase the likelihood of young people having sex, but does reduce the transmission of HIV, unwanted pregnancy and sexually transmitted infections. Some of our local partners share religious beliefs that prevent them promoting condom use to young people within their communities, and so work with us because we can. We promote condom use, abstinence and fidelity as part of our Safer Practises information.
Look out for more blogs and opinion pieces from TackleAfrica staff, volunteers, partners and beneficiaries
How are you attempting to tackle the ways in which patriarchal societies stifle progress in this area. You described some of the ways in which such societies exacerbate the situation (usually by suppressing women’s choices), but are there any methods for educating men in such environments?
About 80% of our beneficiary group are young men and we have specific training modules and drills based on the importance of group decision making in relationships, respect for women, freedom of choice and more. We feel that positively affecting male attitudes to women is a key aspect of a successful HIV intervention, and we find football is an extremely useful vehicle to do so.
Using female coach educators is another way both to attract more female players and affect male attitudes by providing an authoritative female role model in a traditionally male-dominated environment