Editor's Note: World AIDS
2002—On Condoms and Needle Exchange
by Charles Clifton
Russia
Nowhere in the world is HIV
spreading faster than in the former Soviet Union, an ominous
trend that has so far been driven almost exclusively by the
young embracing drug experimentation. And yet Russia has devoted
little if any attention to the prevention and treatment of
drug abuse. Ninety percent of Russians infected by HIV are
intravenous drug users. Researchers estimate that two out
of every five intravenous drug users already are infected
with HIV, said Andrei Kozlov, one of Russia’s leading AIDS
researchers.
Other former Soviet republics
faced with rapid increases in the spread of HIV have begun
methadone programs to help reduce the incidence of intravenous
drug use. In Russia, however, methadone is illegal. Needle
exchange programs benefit about 5 percent of the country’s
intravenous drug users, said one expert. But to make a significant
dent in the spread of HIV among that group, at least 60 percent
coverage is needed.
India
A condom festival was launched
in the southern Indian state of Andhra Pradesh as part of
an HIV/AIDS prevention program. According to a National AIDS
Control Organization study, condom usage in Andhra Pradesh
is the lowest in the country. One of the reasons for the low
condom use is said to be the high rate of sterilization in
the state. “People may think that because they have undergone
sterilization, there is no need for condoms,” said Dr. Kadambari,
head of Andhra Pradesh’s HIV/AIDS program. Andhra Pradesh’s
Health Minister N. Janardhan Reddy added, “Because they are
not following safe sex measures, AIDS is spreading. So we
want to promote the use of condoms.”
Vietnam
Vietnam has unveiled a plan
to stem escalating HIV infection rates by boosting condom
usage among its sexually active younger population. The campaign
aims to sell 170 million condoms each year through 2005, said
Phan Song, director of Vietnam’s Family Planning Association.
Many Vietnamese men do not use condoms, primarily because
of ignorance about HIV/AIDS/STDs. Embarrassment about buying
contraceptives in Vietnam’s deeply traditional society also
remains a factor, sociologists say. “This campaign not only
aims to serve family planning issues but more importantly
is to protect people against HIV/AIDS, given that 58.7 percent
of HIV carriers in Vietnam are aged between 13 and 29,” Song
said.
Dr. Joseph O’Neill, Director
of the White House Office of National AIDS Policy at the United
States Conference on AIDS, September 2002
On condom use and “abstinence
only education”:
“This epidemic is spread
by many human behaviors. That is not a moral statement. It
is a statement of fact. We know there is a strong correlation
between the number of sexual partners and risk for HIV. Reducing
that number to one life partner is the safest of all. This
is an extremely important message, especially for young people,
gay or straight.”
“An approach that says
the only human behavior that matters is condom use is wrong—it
is medically wrong. Bringing the abstinence voice into the
discussion is helpful, and the right thing to do. A clear
unambiguous message to our young people that making the right
choice with their bodies is a message worth giving.”
On needle exchange:
“The administration’s
position on this is clear, as was the case in the last administration,
which did not support the federal use of dollars for needle
exchange. We do not oppose the use of state, local and private
funds for this purpose, but we believe it’s the wrong priority
for federal funds. But we believe in substance abuse treatment.
We know it can be treated successfully. And we think it wrongheaded,
and we don’t think there are enough treatment slots available
in this country to divert public dollars to needle exchange.”
