Condoms vs Abstinence Divides World AIDS Conference

President Yoweri Museveni's comments on the second day of the International AIDS Conference were in line with the policy of U.S. President George W. Bush but at odds with a majority of researchers and AIDS activists at the meeting.

Condoms have been promoted as a front line defense against AIDS by countries such as Thailand where a campaign to get sex workers to insist on condoms yielded a more-than-sevenfold reduction in HIV rates in 13 years.

An epidemiologist tracking Asia's emerging epidemics told conference delegates that additional countries - including China and Bangladesh - face HIV problems largely driven by prostitution, and that promoting condoms is best to block further spread.

``I disagree with (Museveni) ... condoms are greatly shortchanged in Africa as a prevention method,'' said Tim Brown, of the Hawaii-based think-tank East West Center. ``If you increase condom use by 50 per cent, I guarantee you that HIV will go down by 50 per cent.''

Uganda has waged a successful battle against the spread of HIV in a rare success story for sub-Saharan Africa - though some experts say it's unclear how that success has been achieved.

Museveni said loving relationships based on trust are crucial, and that ``the principle of condoms is not the ultimate solution.''

``In some cultures sexual intercourse is so elaborate that condoms are a hindrance,'' he told a conference plenary session. ``Let the condom be used by people who cannot abstain, cannot be faithful, or are estranged.''

Museveni, in a departure from many western proponents of abstinence before wedlock, said marriage should be flexible, and that sticking with someone when a relationship turns sour might mean that an unfaithful partner brings home an infection.

``Ideological monogamy is also part of the problem,'' he said.

Uganda pioneered a strategy that later became known as ``ABC'' or ``Abstinence, Being faithful, and Condoms'' - in that order - a policy backed by Bush. Critics have said promoting condoms should come first.

Uganda has brought its infection rate down from more than 30 per cent in the early 1990s to about six per cent of the country's 25 million people last year.

Many conference delegates criticized the Bush administration's AIDS funding initiatives for requiring that one-third of the money allotted for HIV prevention support 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,'' U.S. Congresswoman Barbara Lee said, presenting a report by family planning group Population Action International.

Lee, a California Democrat, and other delegates urged more spending to expand the availability of affordable condoms in the developing world. Activists at a youth session punctuated those demands with a song to the tune of Queen's We Will Rock You - with the lyrics, ``We want, we want protection!''

Some 25 million of the 38 million infected with HIV worldwide are in sub-Saharan Africa, but the virus is taking root increasingly in Asia, where 7.6 million are infected.

In Asia, the sex trade has been the main engine behind infections in countries such as Thailand and Cambodia, where epidemics exploded by the late 1980s - sparking aggressive responses including campaigns to boost condom use, said Brown.

Other Asian countries where the proportion of men who visit prostitutes is lower will face the same problem but more slowly.

``The slowly evolving epidemics of Asia are very dangerous, because they will grow steadily and silently,'' Brown said, and are less likely to prompt aggressive government responses.

Brown said China and Bangladesh are potential hotspots because their rate of condom use is only about 10 per cent.

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