LETTER: Abstinence and Fidelity Won't Win AIDS Battle

Thursday, 31 May, 2007
Wall Street Journal

In the fight against AIDS, people tend to pit abstinence and fidelity against condoms ("Why an AIDS Fight Faces Delay," Politics & Economics, May 21). That is a false dichotomy. The dynamics of HIV transmission vary from country to country, and HIV prevention strategies must be tailored to respond in each context. Prevention strategies must give individuals a range of realistic choices to protect themselves and must reduce barriers that prevent people from making those choices.

For example, promoting fidelity and condoms is insufficient in cultures where husbands tend to be unfaithful and wives powerless to negotiate condom use. Similarly, abstinence campaigns won't help young girls who are sexually exploited or forced into early marriage. CARE's experience indicates an urgent need to go beyond ABC (abstinence, fidelity and condoms) to increase the power of the most vulnerable people -- particularly women and girls -- to protect themselves. We recommend removing the spending requirement for "abstinence-until-marriage" programs in developing countries, not for political purposes but for a very pragmatic reason. This "earmark" hinders the development of flexible prevention strategies tailored to each specific context and makes meeting a spending target a goal in itself.

It is time to move beyond the debate about "more abstinence" or "less abstinence" and focus on the real challenge: the most effective and comprehensive use of all HIV prevention approaches at our disposal to save as many people as possible from HIV infection.

Helene D. Gayle

President and CEO

CARE

Atlanta