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Abstinence, Fidelity More Effective in HIV/AIDS Prevention, Says Harvard Researcher

A senior research scientist with the Harvard Center for Population and Development Studies states that abstinence and fidelity is far more effective than just promoting correct condom use.

LAKE FOREST, Calif. – Abstinence and fidelity are far more effective than just promoting correct condom use, said a senior research scientist with the Harvard Center for Population and Development Studies at the first-ever HIV/AIDS conference hosted by a local church last week.

Dr. Edward Green – who has evaluated AIDS prevention in Uganda and was perhaps the first researcher to make Uganda’s ABC (Abstaining from sex, Be faithful, Correct and Consistent use of Condoms) program known to the rest of the world – promotes the idea that the first priority in HIV/AIDS prevention should be abstinence for youth and mutual fidelity for adults. The anthropologist was a keynote speaker at the “Disturbing Voices” HIV/AIDS conference at Saddleback Church on Nov. 30.

Green’s support of abstinence and fidelity runs counter to his colleagues’ who advocate the use of condoms and clean needles to prevent the spread of HIV/AIDS.

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“When I come back from a standard AIDS conference I am upset. They just talk about drugs and condoms but not sexual behavior to try to control the disease,” said Green at the introduction to the session titled, “Rethinking AIDS Prevention.”

“Most infections are still sexually transmitted. It’s like talking about lung cancer but not talking about smoking behavior,” continued Green. “It was taboo to talk about HIV/AIDS and sex behavior.

Green, a self-described liberal and once promoter of the use of condoms and clean needles, began to champion the ABC model of AIDS prevention after his evaluation of the program in Uganda, a country with HIV prevalence at 15 percent in 1991 that fell to 5 percent by 2001.

“During this period, abstinence increased among youth and condom use increased somewhat. Most critically, ‘B’ behaviors (fidelity and reduction in the number of sexual partners) increased dramatically,” Green noted during the second day of the three-day conference.

Green discussed the importance of behavior change in the prevention of HIV/AIDS, a topic that Saddleback Pastor Rick Warren spoke earlier about in the conference, noting that only the church had the power to change behavior.

“The most important behavior change for HIV prevalence decline is fewer sexual partners and fidelity,” Green declared.

“The ‘B’ (behavior) is most important,” Green told attendees. “The ‘A’ is important, but most Africans are not abstaining. Most are married and faithful, contrary to Western perception. We think that Africans have wilder and crazier sex than Americans, but they don’t.”

The research scientist went on to explain that although all elements of the ABC approach are necessary, emphasis on each prevention method will have to vary according to the target population.

Dr. Edward Green has had more than 30 years of experience in public health in Africa, Asia, the Caribbean and he has focused on AIDS prevention since the emergence of the pandemic. Prior to that, he worked in family planning and reproductive health. He has also worked in areas of sexually transmitted diseases, primary health care, human resources development, maternal and child health, children affected by war, child nutrition, water and sanitation, environmental health, refugee issues, and mental health.

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