Aids meeting debates abstinence versus condoms

4.00pm

BANGKOK - A controversy erupted at a global AIDS conference on Monday over whether abstaining from sex or using condoms was more effective to prevent the disease.

Ugandan President Yoweri Museveni brought the issue, which has set many AIDS activists at odds with the United States, into the open at the first full day of the AIDS conference by saying abstinence was the best way to stem the spread of the killer virus.

The remarks by Museveni, whose country is a rare success story in Africa's war on Aids, were at odds with health experts who back condoms as a frontline defence against the incurable disease.

"I look at condoms as an improvisation, not a solution," Museveni told delegates on the second day of the 15th International Aids Conference in Bangkok.

Instead, he called for "optimal relationships based on love and trust instead of institutionalised mistrust which is what the condom is all about."

Museveni added fuel to a debate within the Aids community over the best way to halt the spread of a disease that has killed 20 million people and infected 38 million. Uganda's "ABC" method (Abstinence, Being faithful and Condoms) is a model for the Aids policies of the administration of President Bush and which are under fire at the conference for advocating sexual abstinence to stem infection.

This year's smaller US delegation, which the United States says reflects a desire to cut costs, is seen partly as a sign of Washington's displeasure that its approach appears to have had little influence on the agenda.

US Congresswoman Barbara Lee, the only member of Congress to attend the week-long meeting, accused the Bush administration of using ideology, not science, to dictate policy.

She said the US Aids initiative requires that one-third of prevention funding go to "abstinence until marriage" programs.

"In an age where five million people are newly infected each year and women and girls too often do not have the choice to abstain, an abstinence until marriage program is not only irresponsible, it's really inhumane," Lee said.

" Abstaining from sex is oftentimes not a choice, and therefore their only hope in preventing HIV infection is the use of condoms," she added.

But Ted Green, a member of Bush's council on Aids, said programs aimed at changing sexual behaviour were not obtaining funding. He also questioned the focus on condoms.

"If you are telling me that people can't stop Aids unless they buy a product. I simply don't agree with that," he said.

Simon Onaba, a Uganda youth delegate who first had sex at age 15 but shunned it for the past three years, said condoms were not a 100-per cent guarantee against infection.

"I am abstaining," Onaba said as he described Uganda's campaign to change behaviour by urging young people who were most vulnerable to abstain or be faithful, and if needed use a condom.

"I am a sexual being, but I recognise HIV/AIDS is a killer," said Onaba. "I will wait until my wedding night."

Official figures suggest six per cent of Uganda's 26.5 million people are now infected, down from 30 per cent in the 1980s.

But Uganda's success has been twisted by the US government in an effort to keep the support of religious conservatives, said Steven Sinding, director general of the International Planned Parenthood Federation.

"It appears that this is naked pandering to an extremist constituency," Sinding said.

"Millions of people around the world have been persuaded by the arguments of the US government and religious right. Their actions represent a setback in bringing HIV/AIDS under control."

Health experts point to countries such as Thailand where a heavily promoted condom campaign is credited with slashing infection rates among sex workers in the 1990s.

In Asia, where infection rates are rising among injecting drug users, young people and homosexuals, some NGOs advocate the "CNN method" which stresses condoms, needles and negotiation.

Helene Gayle, head of AIDS programs for the Bill and Melinda Gates Foundation, said one approach was not better than the other.

"The debate is more distracting than it needs to be because we need to get on to the business of saving lives."

- REUTERS