The president of Uganda, Yoweri Kaguta Museveni has caused a major divide among participants at the 15th International AIDS Conference in Thailand by stating that abstinence and marriage are the best ways to stop the spread of the HIV/AIDS epidemic.
He said, "the use of condoms is not the ultimate solution in the fight against HIV-AIDS. Uganda has been one of the few African nations to successfully reduce its AIDS infection rate, using what has become known as the ABC method - Abstinence, Being Faithful and Condoms."
The HIV/AIDS story in Uganda is one of rare success for the African continent.Since the Ugandan government created the ABC program infection rates have fallen from 30% to about 6% of the Ugandan population.
Latex condoms, when used consistently and correctly, are highly effective in preventing transmission of HIV, the virus that causes AIDS.*
- Using a latex condom to prevent transmission of HIV is more than 10,000 times safer than not using a condom.
- A study published in The New England Journal of Medicine observed heterosexual couples where one was HIV-positive and the other was HIV-negative, for an average of 20 months. (These couples are referred to as sero-discordant.) Findings included:
- No sero-conversion occurred among the 124 couples who used latex condoms consistently and correctly for vaginal or anal intercourse.
- Ten percent of the HIV-negative partners (12 of 121) of couples became infected when condoms were used inconsistently for vaginal or anal intercourse. In contrast, 15 percent of HIV-negative partners became infected when condoms were not used.
- A study published in The Journal of Acquired Immune Deficiency Syndromes observed sero-discordant heterosexual couples and showed that only three out of 171 who consistently and correctly used condoms became HIV infected
- eight out of 55 who used condoms inconsistently became HIV infected
- and eight out of 79 who never used condoms became HIV infected.
In the past, public health experts recommended using condoms combined with Nonoxynol-9 (N-9), a spermicide, for increased protection against pregnancy, HIV, and STD's. Two recent studies, however, call into question the effectiveness and safety of N-9.
A study published by UNAIDS found that N-9 used without condoms was ineffective against HIV transmission. This study actually showed some evidence that N-9 increased the risk of HIV-infection.
Researchers note that this study was conducted among commercial sex workers in Africa who are at increased risk and used a N-9 gel on a frequent basis. The adverse affects might not be seen at the same level among women who are using N-9 less frequently or in a different formulation.
As a result of this study, however, the CDC concluded that "given that N-9 has been proven ineffective against HIV transmission, the possibility of risk, with no benefit, indicates that N-9 should not be recommended as an effective means of HIV-prevention."
A similar study published in the Journal of the American Medical Association found that N-9, when used with condoms, did not protect women from the bacteria that causes gonorrhea and chlamydial infection any better than condoms used alone.
*. F. Carey, et al., "Effectiveness of Latex Condoms As a Barrier to Human Immunodeficiency Virus-sized Particles under the Conditions of Simulated Use," Sexually Transmitted Diseases, July/August 1992, vol. 19, no. 4, p. 230.