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New infections outpace treatment

This from the Kaiser Family Foundation reports:

HIV/AIDS Treatment Programs Will Not Keep Pace Unless Number of New Cases Decreases, Experts Say at PEPFAR Reauthorization Hearing
[Dec 12, 2007]
HIV/AIDS treatment programs in Africa will not be able to keep pace unless the number of new cases significantly decreases, experts said Tuesday at a Senate Health, Education, Labor and Pensions Committee hearing to reauthorize the President’s Emergency Plan for AIDS Relief, the Boston Globe reports (Donnelly, Boston Globe, 12/12).

I agree with the critics that Congress’ mandated spending requirements on prevention money are insane, but I disagree with those who think that if we just dump all our prevention money into condoms that will solve things. If you are married woman in the developing world, what chance do you have of forcing your husband to always use a condom? He may have a long-term girlfriend on the side which increases the risk to him and you, but asking your husband to use a condom potentially puts woman at great personal risk of abuse.

Here, one expert suggests that condoms are not the main answer and that abstinence and faithfulness policies have a role to play as part of prevention.

Experts at the hearing testified that the “most important battle” in curbing HIV/AIDS is stopping HIV transmission but disagreed on how to stop the spread of the virus, the Globe reports. Some witnesses at the hearing debated the effectiveness of a PEPFAR requirement that one-third of HIV prevention funds focus countries receive through the program be used for abstinence-until-marriage and fidelity programs (Boston Globe, 12/12).

Norman Hearst, a professor at the University of California-San Francisco School of Medicine, said that encouraging married men to be faithful to their wives and delaying the onset of sexual intercourse are the two main ways to stop the spread of HIV in Africa (Walker, CQ HealthBeat, 12/11).

According to Hearst, programs that focus on promoting condom use have “never worked” in areas where HIV is generalized (Boston Globe, 12/12). “It’s easier to change sexual behavior than getting the people to use an imported sexual device all of the time,” Hearst said (CQ HealthBeat, 12/11).

At the end of the day, it still seems that people are grasping for answers on prevention. Hence, the interest in male circumcision.

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