remember those teenage abstinence pledges?

[pchang]

Originally posted by Ben Kenobi


Depends also on how likely each item is to protect the user and how hard each one is to use.

Construction sites require hardhats and boots, so I fail to see how two items are nearly as complex as four.

Secondly, if one forgets a hardhat, it is immediately obvious to his workmates if he forgets the hat. The same is not true for birth control. A man has no way of knowing whether or not his partner has in fact used birth control.

I think lack of a condom is immediately noticeable.

[Boris Godunov]

There's also some problems with promoting Uganda as a model for the rest of Africa:

http://www.aaanet.org/press/an/infocus/0310_feldmanaids.htm

From the October 2003 Anthropology News, p 6
Problems with the Uganda
Model for HIV/AIDS Prevention

Douglas A Feldman
SUNY Brockport

With $15 billion available over the next five years from the US for HIV/AIDS prevention, care, and treatment in 12 African, one Caribbean, and one South American countries, it has become a hotly debated political question of how the money should be spent. The religious right and conservative politicians in the US have strongly argued that both domestically and in Africa condom use promotes “immorality” (“promiscuous” pre-marital and extra-marital sex). Thus, they advocate that all HIV prevention funding should promote abstinence-only programs for youth and adults who are not married and fidelity-only programs for monogamous married couples. With the assistance of Edward C Green, the Bush Administration and the Republican dominated Congressional House have “discovered” that Uganda might serve as a perfect model in the rest of Africa for their morality-based HIV prevention agenda. Indeed, President Bush made certain that Uganda was on the schedule for his recent five-nation Africa tour, where he lauded their abstinence/fidelity-based approach.

Green argues in favor of applying the “Uganda model” to all of Africa by emphasizing sexual abstinence before marriage and marital fidelity during marriage, while de-emphasizing condom use and sexually transmitted infections (STI) treatment. However, this politically conservative approach to HIV prevention in Africa is based upon several false assumptions of what actually happened in Uganda that caused the HIV seroprevalence rate to decline, the nature of the epidemic in Africa, and the value of condom use and STI treatment in HIV prevention. Green believes that the Ugandan ABC religious-based approach of promoting “Abstinence, Be faithful, or use a Condom” is unique to Uganda, and explains why the HIV rates significantly declined. But the truth is that this approach has also been tried in most African nations, with little or no success.

The difference is not the message, but how the message was conveyed. In Uganda, beginning in 1986, the government, together with the national media, very aggressively de-stigmatized the disease by discussing the epidemic openly. Public discussions about sex and HIV occurred in schools, public meetings and in the workplace. The wall of denial about AIDS, impenetrable throughout most of the rest of the continent, came tumbling down in Uganda. The immediate reaction, before condoms could be made widely available, was a sharp reduction in partners based upon fear of the disease. Today, condom use in Uganda is rapidly growing as the intensity of the fear has subsided.

Condoms, both male and female condoms, remain perhaps the single most effective tool we have in lowering HIV seroprevalence today among the sexually active. A recent analysis by the World Health Organization (WHO) indicates that there is indeed a 10% failure rate with condoms, mostly through misuse, and that condoms are not perfect. But there is no question that if everyone in Africa who is sexually active, and not actively seeking to have children with their partner, were to use condoms properly every time, the HIV epidemic would substantially diminish throughout that continent. The fact is, with only 4.6 condoms used annually per adult male in Africa, that condoms have barely been tried.

There has been a growing religious fundamentalism during the 1980s and 1990s throughout many African nations, including Uganda, pushed primarily by American-based evangelical organizations (such as Pat Robertson’s Christian Coalition and 700 Club and Sammy Tippett’s Ministries). The wide diversity of traditional African religious thought and philosophy has increasingly collapsed into a narrow and bigoted cosmology from the most conservative elements of American Christianity. Complicating matters, during the mid-1980s WHO insisted that the HIV prevention messages in Uganda be simplified to a single message (“ABC”), ignoring the diverse at-risk populations within that nation which needed to be separately targeted.

Appealing to religious fundamentalism and sex-negative messages in Africa is not the answer. We need to recognize that our messages need to be tailored to different segments of the African population, including sexually active persons who wish not to be either celibate or monogamous. Culture-specific, ethnographic-based social marketing is needed throughout Africa to effectively promote condom use. HIV prevention programs, especially in rural areas, need to be tailored for the BaGanda, Bemba, Lozi, Mossi, Igbo, Yoruba, Maasai, Turkana, Azande, Shona, and many others, rather than pre-packaged in the State of Texas. Governments and their national media need to eliminate denial and de-stigmatize the disease. We need to work with traditional healers, encourage voluntary HIV counseling and testing, treat other STIs, educate men and empower women–and we need more than a prayer to make this happen.

Douglas A Feldman, applied medical anthropologist, has been active in AIDS research and policy since 1982. His latest book is The AIDS Crisis: A Documentary History (1998).

[Boris Godunov]

And here's info from WHO which sheds a different light than the fundie interpretation of Uganda:

http://www.who.int/inf-new/aids2.htm

Uganda reverses the tide of HIV/AIDS
Uganda's success in reducing high HIV infection rates is the result of high-level political commitment to HIV prevention and care, involving a wide range of partners and all sectors of society. Same-day results for HIV tests and social marketing of condoms and self-treatment kits for sexually transmitted infections, backed up by sex education programmes, have helped reduce very high HIV infection rates.

Uganda, one of the first countries in sub-Saharan Africa to experience the devastating impact of HIV/AIDS and to take action to control the epidemic, is one of the rare success stories in a region that has been ravaged by the HIV/AIDS epidemic. While the rate of new infections continues to increase in most countries in sub-Saharan Africa, Uganda has succeeded in lowering its very high infection rates. Since 1993, HIV infection rates among pregnant women, a key indicator of the progress of the epidemic, have been more than halved in some areas and infection rates among men seeking treatment for sexually transmitted infections have dropped by over a third.

In the capital city Kampala, the level of HIV infection among pregnant women attending antenatal clinics fell from 31% in 1993 to 14% by 1998. Meanwhile, outside Kampala, infection rates among pregnant women under 20 dropped from 21% in 1990 to 8% in 1998. Elsewhere, among men attending STI clinics, HIV infection rates fell from 46% in 1992 to 30% in 1998.

Success in reducing the prevalence of HIV in Uganda is the result of a broad-based national effort backed up by firm political commitment, including the personal involvement of the head of state, President Yoweri Museveni. From the outset, the government involved religious and traditional leaders, community groups, NGOs, and all sectors of society, forging a consensus around the need to contain the escalating spread of HIV and provide care and support for those affected.

Sex education programmes in schools and on the radio focused on the need to negotiate safe sex and encouraged teenagers to delay the age at which they first have sex. Since 1990, a USAID-funded scheme to increase condom use through social marketing of condoms has boosted condom use from 7% nationwide to over 50% in rural areas and over 85% in urban areas. The social marketing scheme involved sales of condoms at subsidized prices or free distribution by both the government and the private sector. The scheme was also backed up by health education and other public information. Meanwhile more teenage girls reported condom use than any other age group -- a trend reflected in falling infection rates among 13-19 year old girls in Masaka, in rural Uganda. And among 15-year-old boys and girls, the proportion who had never had sex rose from about 20% to 50% between 1989 and 1995.

Condom use is also being encouraged among men who seek treatment for sexually transmitted infections. A new innovative social marketing scheme to promote the use of an STI self-treatment kit ("Clear Seven") has proved to be successful in treating STIs and preventing HIV infection. The kit, which contains a 14-day course of tablets, condoms, partner referral cards, and an information leaflet, is designed to improve STI treatment rates, prevent over-the-counter sales of inappropriate treatments, encourage partner referral, and reinforce condom use. The distribution system relies on the use of small retail outlets which are normally licensed to sell over-the-counter drugs but not antibiotics. The Ugandan Government has waived these restrictions to promote sales of Clear Seven, marketed at the subsidized price of US$ 1.35, and trained shopkeepers in the management of STIs. As a result, cure rates for urethritis have increased from 46% to 87% and condom use during treatment has more than doubled (from 32% to 65%).

Another innovation in Uganda was the launch in 1997 of same-day voluntary counselling and testing services. Up till then, clients had to wait two weeks for their HIV test results and up to 30% failed to return. Thousands of people who have taken advantage of same-day testing have since been recruited and trained as peer educators. So far, 180 000 people have been reached by the scheme and over a million condoms distributed.

In Uganda, as elsewhere in sub-Saharan Africa, AIDS has caused immense human suffering over the past two decades -- setting back development and reducing life expectancy. Over 1.5 million children have been orphaned since the epidemic began -- losing their mother or both parents to AIDS. Today there is hope that the tide can be turned at last.

[Ben Kenobi]

I'm asking you to show significant numbers of these things happening... not in the Benaverse, but in demonstrable statistical form. Its not a problem or a "normal or natural situation" if you can only point to rare anecdotes as foundation.

Quid pro quo, Ben. Put up, or give up.

Read what you quoted. I'll construct my argument so that you can understand.

1. Responsible parents, with the capacity to take care of their children, do so.

2. Not all children are taken care of by their parents.

Ergo,

Not all parents are responsible, or they do not have the capacity to do so.

To prove premise 2, I only need one case, and do you begrudge me that?

[GePap]

Oh, and I see ben avoid all my posts, I gues smainly becuase they demolish his condom arguement.

[Ben Kenobi]

Abstinance does have a 100% effectiveness-IF people do it correctly and understand what abstinance actually asks of them. If they do not, they will screw up and get adverse results.

And we do not see the same thing with condoms. That is my point. Condoms, even in an ideal world, will not always work. This is the primary difference between them and abstinence.

[Ben Kenobi]

Oh, and I see ben avoid all my posts, I gues smainly becuase they demolish his condom arguement.

Close, very close to a cross-post.

Just a hair too slow.

[Ben Kenobi]

I think lack of a condom is immediately noticeable.

True, but the argument was not just for condoms, but for 4 methods in combination.

[Ben Kenobi]

Green believes that the Ugandan ABC religious-based approach of promoting “Abstinence, Be faithful, or use a Condom” is unique to Uganda, and explains why the HIV rates significantly declined. But the truth is that this approach has also been tried in most African nations, with little or no success.

Boris,

ABC is not abstinence only. False analogy.

Green is NOT defending ABC as your article insists, rather he is favouring the abstinence only approach pushed by the government and REJECTED by the NGOs.

[GePap]

Originally posted by Ben Kenobi


And we do not see the same thing with condoms. That is my point. Condoms, even in an ideal world, will not always work. This is the primary difference between them and abstinence.

Yes, and the point of the thread is that teengares simply being told "do not have sex" does NOT work better-why?

First, they find ways to keep the letter of the pledge while breaking the spirit-getting married before they are ready simply to have sex

They diddle with deifnitions: after all, if sex is about kids, types of intercourse that do not lead to pregnancy must be OK-hence anal and oral sex.

The fact is Ben you just used a piece that used the very same logic as that of this thread to attack the thread-which is, well a logical problem.

[Ben Kenobi]

Success in reducing the prevalence of HIV in Uganda is the result of a broad-based national effort backed up by firm political commitment, including the personal involvement of the head of state, President Yoweri Museveni. From the outset, the government involved religious and traditional leaders,

So, even your source denies that condoms are the solution for the problem, but rather claims that the NGOs were responsible for turning the tide.

Hardly surprising given that the NGOs want to retain their influence in Africa.

Everywhere they have tried to give condoms, will not reduce the seroprevalence rate in Africa. Again, the one country that rejected the ABC approach has seen success, where all the countries that have used them have not.

[Ben Kenobi]

Yes, and the point of the thread is that teengares simply being told "do not have sex" does NOT work better-why?

It's hard to remain abstinent without adequate support from society.

First, they find ways to keep the letter of the pledge while breaking the spirit-getting married before they are ready simply to have sex

Why is that breaking the spirit? The spirit of the pledge is to wait until marriage to have intercourse.

They diddle with deifnitions: after all, if sex is about kids, types of intercourse that do not lead to pregnancy must be OK-hence anal and oral sex.

Who diddles with the definitions? The kids or the folks who suggest they try a pledge? That is against the spirit of the pledge, not getting married at a young age.

The fact is Ben you just used a piece that used the very same logic as that of this thread to attack the thread-which is, well a logical problem.

How so? The piece cited provided evidence that abstinence programs ARE having some effect. 11% is nothing to sneeze at, particularly since these programs are just getting started.

Again, I will repeat myself, because I think this is so important, and highlighted by Boris's article. Abstinence will not work in a vacuum. People need support and encouragement, and most teenagers do not find such support and encouragement from their peers.

Rather, they are ridiculed for this approach, or callously told by the folks who should encourage them, to JUST USE A CONDOM.

I know. I've been there. I found it very hard, but I'm happy I waited.

[GePap]

Originally posted by Ben Kenobi
Why is that breaking the spirit? The spirit of the pledge is to wait until marriage to have intercourse.

Ok, so it is better for tow kids to, simply out of lust, get married so they can have sex (unprotected most likely), find they were not ready, become unhappy, and up in a divorce, or have two kids have sex (perhaps protected), then decide they are not best together and move on....Well, i guess ia a doctrinarian world which cares more about words in books that human lives, that makes sense.

How so? The piece cited provided evidence that abstinence programs ARE having some effect. 11% is nothing to sneeze at, particularly since these programs are just getting started.

It is so becuase you used it party as a way to paint condoms as ineffective, while the piece said condom education was ineffecitve not becuase condoms are foolproof but becuase of misinformation about them in asfirca, thus a "just condom's" approach would fail. Just like a "just say no" approach is not significantly effective.

[Spiffor]

Damn, I leave for four hours to play a game of SMAC, and I still see you arguing over it?

Really folks, aren't there more interesting thread to spam out there?

[Gibsie]

Originally posted by Ben Kenobi
How so? The piece cited provided evidence that abstinence programs ARE having some effect. 11% is nothing to sneeze at, particularly since these programs are just getting started.

That's 11% who do manage to wait, and 88% who do not. So almost 90% of the kids who do take the vow do not live up to it, and these are the kid who believe what they are told by people like you, that condoms are pretty much worthless and provide little to no protection from STD's. That's 90% who will go out and have sex, and probably not bother with condoms, and could pick up and STD or make a baby as a result.

And you're happy with this? That the vast majority of those kids that the groups are supposedly setting out to help, to have avoid the negative consequences of sex, that these kids are put more at risk from those consequences as a result? You're pleased by that? 100 kids take a vow, 88 of them will fail and have a much much higher chance of engaging in risky sex practises than their more educated peers, and that is a success? I would hate to see what you would consider a failure.