The fight against Aids cannot be won by relying solely on condoms, Ugandan President Yoweri Museveni said at the International Aids Conference in Bangkok on Monday.
Museveni, credited with slashing HIV infection rates in Uganda, said that abstinence, loving relationships and marriage are even more crucial than relying on condoms to halt the spread of Aids.
Museveni’s comments on the second day of the conference echoed those of United States President George Bush, but are at odds with the views carried by the majority of researchers and activists involved in fighting the disease.
Condom use has been promoted as a frontline defense in the fight against Aids by countries such as Thailand where an aggressive pro-condom campaign yielded a massive reduction in HIV rates.
Just before Museveni’s speech, Tim Brown, an epidemiologist tracking Asia’s emerging epidemics told delegates that a number of countries — including China and Bangladesh — face HIV problems largely driven by prostitution. According to Brown promoting the use of condoms is the most effective way to prevent further infections.
Museveni, however, said loving relationships based on trust are crucial in the fight against HIV, and that ”the principle of condoms is not the ultimate solution”.
He also told the conference plenary session: ”In some cultures sexual intercourse is so elaborate that condoms are a hindrance. Let the condom be used by people who cannot abstain, cannot be faithful, or are estranged”.
Museveni, in a departure from the stance of some of his Western supporters, said the concept of marriage should be flexible, and that sticking with someone when a relationship turns sour opens the possibility of an unfaithful partner bringing an infection home.
”Ideological monogamy is also part of the problem,” Museveni added.
Uganda has waged one of the world’s most successful battles against the spread of HIV in a rare success story for sub-Saharan Africa.
It has enlisted religious groups to help spread information, and 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 be the first priority.
It has brought the infection rate down from more than 30% in the early 1990s to about 6% of the country’s 25-million people last year.
Last month, Uganda pledged to provide free generic Aids drugs to the 100 000 of the country’s 500 000 HIV-infected people who have developed full-blown Aids — a major theme of conference delegates who want newly available generic drugs distributed more effectively.
About 25-million of the 38-million infected with HIV worldwide live in sub-Saharan Africa, but the virus is increasingly taking root in Asia, where almost eight million people are infected.
In Asia, the sex trade has been the main catalyst behind infections in countries such as Thailand and Cambodia, where epidemics exploded in the late 1980s — sparking aggressive responses including campaigns to boost condom use, said Brown, a UNAids coordinator at the Hawaii-based East West Center.
Other Asian countries where the proportion of men who visit prostitutes is lower will face the same problem — but more slowly, Brown added.
”The slowly evolving epidemics of Asia are very dangerous, because they will grow steadily and silently,” Brown said. He added that Asia’s epidemics are less likely to prompt aggressive government responses.
Brown said that a condom usage rate of roughly ten percent makes China and Bangladesh potential hotspots for explosive epidemics. — Sapa