LONDON, May 19, 2008

Rethinking HIV-Condom Strategy In Africa

Campaigns Promoting Safer Sex Ineffective In Africa, Experts Say

  • Photo

     (CBS)

(AP)  When AIDS erupted more than two decades ago, health experts quickly devised a strategy for stopping the disease's spread in the developing world: Distribute free condoms and test for HIV.

Millions of dollars were poured into the campaign led by U.N. health agencies and backed by governments around the world. But what seemed like a natural way to fight the disease had little impact in Africa, the region hardest hit by the epidemic.

Now, many experts are calling for an entirely new approach to fighting AIDS in Africa - saying there is little evidence current strategies work.

"Intuitively, things like condom promotion and HIV testing should work anywhere," said Daniel Halperin, an AIDS expert at Harvard University's School of Public Health.

"But if that were true, countries like Botswana (with Africa's highest prevalence of AIDS after Swaziland) should have wiped out their HIV epidemic by now. These approaches just haven't worked as well as we thought they would."

In a recent article published in the journal Science, Halperin and other AIDS experts argued that health officials are largely wasting money focusing on condoms, HIV testing and other strategies such as vaccine research as the main tools for preventing AIDS in Africa.

Condom use in Africa hasn't reached a high enough level to make a dent on AIDS transmission, and there is scant evidence to show that people change their sexual behavior even when they know their HIV status, according to studies.

In sub-Saharan Africa nearly 21 million people were infected in 2001, according to the UN. Last year, that figure was estimated to be 22.5 million.

And despite years of research into finding an AIDS vaccine, the most promising candidates have failed.

Halperin and his co-authors said health officials should radically boost funding for male circumcision, which can reduce HIV transmission by up to 60 percent, and for programs to educate people to reduce their number of sexual partners.

"Almost 99 percent of the AIDS prevention money is going to things that don't seem to work very well in Africa and almost none of it is going to things that would have a major impact," Halperin said.

U.N. health officials rejected the need for change and said there is some evidence in Asia that condom distribution programs reduce HIV transmission.

They also said they have been working on guidelines to introduce mass male circumcision, but that such a strategy will take years to implement.

"It's not right to say that our approaches have not worked," said Paul de Lay, an AIDS expert at UNAIDS. "We are seeing an impact in the epidemic's decline worldwide linked to our interventions."

Last year, the UN revised its global figures for the number of people with HIV or AIDS from nearly 40 million to 33 million. But that drop was mostly due to new ways of estimating the numbers of people with HIV.

Some experts suggest the decline is due more to a natural leveling off of the epidemic, with infected people dying, rather than to the success of the UN's anti-AIDS strategies.

Earlier this year, the United States, the biggest funder of AIDS efforts in Africa, agreed to triple its spending on combating AIDS on the continent, pledging $10 billion annually over the next five years. The U.N. estimates it will need more than $3 billion by 2010 for HIV prevention efforts in Africa and $15 billion worldwide.

But some experts argue that - more than two decades into the fight against AIDS - the epidemic would have tapered off more by now in the developing world if current methods were effective.

"At the beginning, people said that this was a public health emergency and that we should just get in there and do something," said David Mabey, an AIDS expert at London's School of Hygiene and Tropical Medicine.

"But that was short-sighted. Some things are clearly not working in some countries."

©MMVIII, The Associated Press. All Rights Reserved. This material may not be published, broadcast, rewritten, or redistributed.

Video and Galleries from World

Add a Comment See all 32 Comments
by dan9111 May 19, 2008 10:15 AM PDT
Halperin and other pedophiles are unethical and guilty of blatant research fraud:

http://www.salem-news.com/ printview. php?id=8349

The USAID-funding has continually been aimed at ineffective male circumcision strategies, plainly intended to harm African boys, while allowing the AIDS problem to worsen. Their purpose: distract from the real debate on how all these perverts have been allowed to mutilate American boys for no medical reason. Like pedophiles, their denail is a means of coping with their mental problems.

The foreskin is not a birth defect.
Reply to this comment
by dan9111 May 19, 2008 10:17 AM PDT
The correct link is:
http://www.salem-news.com/printview. php?id=8349
Reply to this comment
by impeach_w May 19, 2008 11:59 AM PDT
The Bush Administration forbade the the distribution of Condoms while only promoting abstinence in Africa. This is Genocide in my opinon. Not using a condom in Africa is Suicide. Either way, there will less people in Africa to feed and use "our" oil.
Reply to this comment
by msay3 May 19, 2008 12:05 PM PDT
"Rethinking HIV-Condom Strategy In Africa"

The condoms just aren''''t big enough.

Posted by dragonwagon5
------------------------------
Either that or they thought they were getting balloons....
Reply to this comment
by catlover912 May 19, 2008 1:28 PM PDT
These are black people. Giving them condoms that fit us white folks isn''t right. They nee the deluxe size!!
Reply to this comment
by briannorwood May 19, 2008 1:35 PM PDT
catlover912

You are ignorant. You have been reported.

+ report abuse
Reply to this comment
by rf35 May 19, 2008 2:13 PM PDT
Halperin is just bitter because he can''t get it up anymore...a common side effect of circumcision. He would feel better if Africa%u2019s men suffered with him. It might also help if he could make up some justification for his genital mutilation.
Reply to this comment
by bcbbkake May 19, 2008 2:39 PM PDT
Since the disease is transferred through bodily fluids, I fail to see how in the world circumcision could possibly cut down in any way on the spread of HIV. I find that comment in the story to be false on its face, and also totally ridiculous. In addition, it is my impression that people in Africa, particularly in the areas where the disease is running rampant, have little or no food, clean drinking water is scarce, and they are generally in a depressed state (whether it be mentally, economically, or both). They probably couldn''t care less about some disease they can''t even see. Under the conditions in which they live, please pardon me for saying this, but death may even be a welcome end to all of their suffering. There is no vaccine forthcoming, drugs that worked to slow the process yesterday don''t work today; the simple explanation (which has been acknowledged by researchers, doctors and the like) is that the disease keeps mutating. There will never be a cure. Sorry to shock any of you who hadn''t figured that one out yet. It is very sad. Educate yourself and those around you. When I was young and active (and I''m not that old), there were about 3 STDs, and we called them venerial diseases then. There are now over 30, many without symptoms, some cannot be cured, and others are deadly. While condoms are not fun, but they can greatly reduce the misery, or death, that will follow unprotected activities. Bless you all.
Reply to this comment
by reedtaz73 May 19, 2008 3:13 PM PDT
Maybe america should try to use our resources to curb crimes against women and children in Africa...Giving them free, small, multi-colored condems in the smallest size possible is a stupid idea that never worked in the states. BTW, mass circumcision would spread the disease...just like makeshift hospitals are doing. Sad, the children never had a chance. Sterilization is the key...hard to sterilize medical instruments and weapons of war without water and source of constant energy.
Reply to this comment
by coppertales May 19, 2008 4:05 PM PDT
The whole thing had fail written all over the program. If you were standing on the street and some stranger came up to you and said you have to use one of these to have ***, what would you say?
Reply to this comment
by ajaxtheleast May 19, 2008 4:05 PM PDT
And now lecturing Africa in condom reform

Bush says he sees no reason above the

3-1/2" accomodating length to waste

the extra material in their manufacture.
Reply to this comment
by emily3451 May 19, 2008 4:07 PM PDT
BCBBKAKE''s comments are shocking to me. As are the claims that circumsision amounts to gentile mutilation. It doesn''t. If circumsision leads to impotence it must be a very small percentage indeed. I wonder why BCBBAKE assumes that all folks in Africa are so miserable that they would welcome death. That is a sad and elitist point of view and I pity the person that would say something as ignorant and insulting as that. As far as his(or her) comment that circumcision couldn''t possibly be of any benifit, well, apparantly it is, who are you to question the scientific community at large? Do you have a college degree at all? Just wondering.
Reply to this comment
by glock4me May 19, 2008 4:18 PM PDT
They are probably filling them up with water and using them as canteens. I could be wrong though.


--------------------------------------------------------------------------------

Posted by dragonwagon5 at 12:45 PM : May 19, 2008

dragonwagon5, that is pretty funny. I would think that the spermicide would give a funny taste. I should have asked some of my girlfriends back when I was single.

Anybody recall that scene from the 40-year-old V1rgin?
Reply to this comment
by kamsack50 May 19, 2008 5:44 PM PDT
I know why so many sexually active men in Africa don''t use the condoms.
Because they don''t want to.
Men don''t like condoms anywhere, but while men in other countries will go along with it for disease control, in
Africa they''ll say f-you.
Reply to this comment
by purocabron1 May 19, 2008 6:46 PM PDT
22.5 million people infected with this horrible disease in Sub-Saharan Africa. You guys making glib remarks about people suffering from this horrible disease only demonstrate that you are sub-human.
BCBBKAKE, you might want to take your own advice about getting an education. Your remarks show how ignorant you are about AIDS and its transmission.
Reply to this comment
by rushlimpdrug May 19, 2008 9:41 PM PDT

Posted by catlover912 at 01:28 PM

I thought your post was very funny.

Too bad the "post police" are out to
do sooo much good as to report a funny
comment.

-don''t tazer me bro''
Reply to this comment
by godofredo29 May 19, 2008 10:12 PM PDT
I''ve said it before and I''ll say it again. There is no tradition for initiating males into the use of condoms. So, it''s no wonder that we see them as anathema to intimacy. If, during *** education, a female the guy is comfortable with would stimulate him to erection and then help him apply the condom after which she would help him to a climax (however that might be accomplished, including intercourse) he might look upon condoms as something pleasurable. Instead, that kind of "hands on" approach to male *** education is taboo. He''s left to figure it all out himself, so who should be suprised if he gets a lot of it wrong--especially when you''ve "cut" him first.
Reply to this comment
by flagship-usa May 19, 2008 10:30 PM PDT
Posted by dragonwagon5 at 10:31 AM : lol

...on another note: The Bill Gates foundation is pumping allot of money into Africa to help with AIDS education in this improvised nation. Although the problem is getting worst. I wonder just what TBGF is really doing? What contribution is it they are making?

...We have failed to find any means that can control the spread of AIDS. From making men wear condoms, to circumcision, to almost cutting off there .icks. I think it is time the scientific community considers sewing up the ladies until this problem is solved. Everything we men have tried, has not worked. Now is the time for the woman to enter the picture, and do their share for helping humanity solve this horrendous life threatening problem.
Reply to this comment
by flagship-usa May 19, 2008 10:50 PM PDT
Circumcision does not prevent AIDS. This study has not been scientifically proven to have any validity. This study should be removed from publication. Circumcision here in the states among blacks and latinos is much higher as a percentage. Although, AIDS among this group of men is also much higher. This contradicts circumcision as a means by which AIDS can be prevented from spreading. This practice is voodoo stuff at best.
Reply to this comment
by juwboy May 20, 2008 5:15 AM PDT
flagShip-usa:

The report doesn''t say that circumcision PREVENTS the transmission of AIDS.

It says that circumcision REDUCES THE RATE of transmission of AIDS.
Reply to this comment
by flagship-usa May 20, 2008 9:03 AM PDT
Posted by juwboy at 05:15 AM : I''ll agree with you- 50/50.
Reducing the spread of HIVAIDS is also a means of preventing HIVAIDS from spreading. (The artical does use the word "prevention" in a other paragraph.

This is a serious problem. STD''s are plaguing our world. There are new strains of infections that are increasing disproportional with regard to what was typical, in past generations. I just read a report stating that "maybe" HIV does not trigger AIDS. We are also seeing a disproportional increase of infections in animals and vegetation. We are hearing reports of disease''s doctors have no idea what it is. Everything here seams to be accelerating, again disproportional to what past generation have seen. Lets stop blaming each other for our sexual habits. We are sexual people, and we like having s.ex - done, end of argument. We are facing a very dramatic problem, and perplexed - coming up with a solution.
Reply to this comment
by flagship-usa May 20, 2008 9:06 AM PDT
I fear this whole industry has become a cash cow.
Reply to this comment
by ccdsswrkr08 May 20, 2008 11:05 AM PDT
"Condom use in Africa hasn''t reached a high enough level to make a dent on AIDS transmission, and there is scant evidence to show that people change their sexual behavior even when they know their HIV status, according to studies."

When did it go from survival of the fittest, to survival of the idiots?
Reply to this comment
by purocabron1 May 20, 2008 11:24 AM PDT
flagShip-usa, could you please let us know where you get your information from. I don''t know about circumcision rates for African Americans, but saying that latinos have a higher rate of circumcision really confounds me. I grew up in a community that was 70% latino and I don''t ever remember seeing a latino male who was circumcised (in the showers after gym). I would venture a guess that less than 10% of latinos are circumcised, although it''s just a guess.
Reply to this comment
by jboxton May 20, 2008 1:02 PM PDT
You can''t go into the jungle and give condoms to a bunch of natives/savages and expect that to work. They still put bones through their noses. How can they be expected to understand the concept of condoms?
Reply to this comment
by dogsoul May 20, 2008 1:19 PM PDT
Sooooooo - what''s the conclusion here???? I mean, Africa is certainly not the ONLY ''developing'' nation - yet it seems to be the standout when it comes to these programs NOT doing much of anything....

Hmmmmm.... what in the world could be unique about Africa that might cause this sort of thing?

Perhaps it''s the lions?

Not sure... but according to my pastor, this is all part of the White Gov''t of America''s plan to rid the world of black people....
Reply to this comment
by flagship-usa May 20, 2008 2:28 PM PDT
purocabron1 at 11:24 AM : You can google the rest.

http://www.cirp.org/library/disease/HIV/
http://hivskeptic.wordpress.com/2008/02/03/rwanda-circumcise-all-men-even-if-it-means-more-hiv-infection/
Reply to this comment
by purocabron1 May 20, 2008 4:38 PM PDT
flagShip-usa, that is some interesting information and I will admit it gets me thinking toward your side of the argument. However, your sources back up my assumptions, as stated in your first source.... "For example, circumcision incidence in the U.S. is lower among poor and Hispanic people.6" That''s kind of where my gut was leading me. However, as I stated, your sources did make some very valid points
Reply to this comment
by purocabron1 May 20, 2008 5:03 PM PDT
flagShip-usa, I also found this doing a google search,

Caucasians have the highest circumcision rate, followed by African Americans and Hispanics. Geographically, the highest rates are found in the Midwest, followed by the Northeast, the South, and the West.

Reply to this comment
by flagship-usa May 20, 2008 6:51 PM PDT
purocabron1 at 05:03 PM : yeah, interesting stuff.

Men that are circumcised are at a higher risk.

Are body(s) is apply suited in fighting off infections. The foreskin makes sense. There is a enzyme that is secreted that will kill germs and organisms that are foreign, including the HIV virus. And I''m sure the act of urinating will also flush out and keep clean this area. Urine can be above or below a ph of 7.0 (-acidic or +alkaline) 7 represents neutrality. Urine is sterile. It could be considered a antiseptic.

Anyway: nice gym (real men are not circumcised)
Reply to this comment
by taylor2124 May 21, 2008 10:02 AM PDT
Might as well try to train monkeys to play the piano. Handing out condoms to Africans..what a joke.
Reply to this comment
by wbwilhite May 22, 2008 7:44 AM PDT
Eggs are bad for you. No wait! Eggs are good for you. Circumcision is good for you. No wait! Ahhh... too late.
Reply to this comment
See all 32 Comments
  • MOST POPULAR
  • Viewed
  • Commented
Latest News
Featured Blogs