Posted on 07/01/2005 10:32:42 AM PDT by Stultis
Anthropologists clash over religion in AIDS strategy
Medical anthropologists disagree on whether religion and abstinence should play a greater role in Africa’s fight against AIDS.
By Christine Casatelli
(July 1, 2005)
HIV infection is on the rise worldwide, but those with the best insight on how cultural strategies can be used to curb it can’t agree on how big a role religion should play.
U.N. Secretary-General Kofi Annan told officials from more than 120 countries in June that the AIDS epidemic is accelerating and that U.N. efforts to lower the number of new infections will likely fall short.
The secretary-general said in a report written for the daylong General Assembly meeting on HIV/AIDS that 2004 saw more new infections and AIDS-related deaths than ever before. Last year alone, another 4.9 million people were infected with HIV/AIDS and 3.1 million more people died because of it, according to U.N. statistics.
Percolating just below the surface is widespread disagreement in the medical-anthropology community about whether efforts to curb the disease in Africa — where AIDS is at its worst — are being undermined by conservative Christians who may care more about morality than mortality.
The field of medical anthropology applies anthropological and social-science theories and methods to questions about health and treatment. Medical anthropologists conduct research in diverse settings ranging from rural clinics to urban hospitals to determine which approaches are more culturally appropriate and effective in improving health.
At issue among medical anthropologists is a strategy known as ABC — Abstain, Be faithful, use Condoms — which offers a wide-ranging approach to prevent the spread of AIDS. Although many researchers agree that comprehensive solutions such as ABC are needed to combat AIDS, there is much debate over whether abstinence and fidelity or condom usage should be emphasized in resource-poor nations that depend on faith-based organizations for much of their health care.
Fanning the flame is a book published in 2003 by Edward C. Green, a medical anthropologist and senior research scientist at the Harvard Center for Population and Development Studies. In his book Rethinking AIDS Prevention, Green argues that religious groups who heavily promoted the abstinence and fidelity components of the ABC approach in Uganda in the 1980s and 1990s helped the nation decrease its HIV prevalence rate from a peak 18 percent in 1992 to a current rate of 7 percent.
The Ugandan experience has fueled efforts among some policy makers in the United States to make abstinence an integral component of its AIDS-prevention strategy. In May 2003, U.S. President Bush signed the HIV/AIDS Act with funding specifically earmarked for abstinence-based prevention education in schools, churches and community centers overseas. The president touted Uganda’s success in emphasizing abstinence and fidelity in the fight against AIDS.
A self-described liberal, Green has said that international funders who rely too much on donors to stop HIV infection are using a Western approach to AIDS prevention. That approach is not effective in places like Africa because it isn’t culturally appropriate, he said.
“I have long said that ‘A’ and ‘B’ interventions reinforce survival instinct, common sense and indigenous teachings and values,” Green said. “Better to build upon that which exists and makes sense than to expect people to adopt an alien technology that no one in the world has adopted consistently.”
Research supports the success of abstinence in AIDS prevention, Green said, but liberal health organizations that spend millions of dollars on condoms don’t want to hear that message. “The failure of the major donors has been to promote only risk-reduction interventions,” he said. “ABC offers risk reduction plus risk avoidance. Broader is better than narrower.”
Other medical anthropologists, however, say that abstinence is not an intrinsic part of traditional African values. “In some African cultures, polygamy was the norm, and it still continues in the countryside today,” said Doug Feldman, a professor of anthropology at the State University of New York College at Brockport.
To improve AIDS-prevention strategies in Africa, the United States should direct more attention to how education and services can be delivered through more culturally appropriate sources, such as traditional healers, Feldman said. The current focus on abstinence is a misguided attempt by some to impose a foreign set of religious values on African nations, he said.
“There are born-again Christians with an antisex, fundamentalist agenda trying to shift ideology in Africa to one that perpetuates stigma and increases homophobia,” Feldman said.
Ugandan President Yoweri Museveni won kudos in the 1980s by raising AIDS awareness, reducing stigmatization and distributing condoms. Lately, he has been increasingly vocal about the virtues of abstinence in the fight against AIDS. “Museveni is very realistic,” Feldman said. “He sees that most of the AIDS funding is coming from the United States, so he knows that he needs to focus on abstinence.”
By dangling grants for abstinence-based programs in Africa, Bush and right-wing members of the U.S. Congress are dictating an HIV policy there that is unrealistic and unsustainable, Feldman said. “The Bush administration is pushing its moral agenda, and it’s going to backfire,” he said.
Religious organizations and religious beliefs do have legitimate roles to play in a coordinated plan to prevent AIDS in developing nations, according to some medical anthropologists. “Let’s be real — we need to look at the total package,” said Elizabeth Onjoro Meassick, a medical anthropologist born in Kenya. “Abstinence doesn’t cost any money, and it gives people some control,” she said.
The beauty of the ABC model is that it provides options, and nobody is left out, Onjoro Meassick said. The concept can also be applied to indigenous practices. “Healers are all very aware of ABC, and they promote all three,” she said.
But the question is which message gets more emphasis and to whom.
Sometimes the answer seems logical, Onjoro Meassick said. “It doesn’t make sense to focus B and C on kids who go to middle school,” she said. By teaching kids to say no, it builds their confidence and gives them a sense of control so that they will be more likely to practice safe sex in the future, she said. The fidelity message can be targeted at married adults, and the condom message can be targeted at those who choose not to abstain or not to be faithful.
Using faith-based organizations in Africa is also a practical idea, she said. “The data says that 30 to 40 percent of health clinics and medical facilities in Africa are run by faith-based organizations,” said Onjoro Meassick, adding that her experience shows there is a willingness on the part of most of these groups to promote condoms to prevent the spread of HIV. Mission hospitals are even beginning to branch out with home-based care to serve AIDS patients and their families who live in rural areas.
Faith-based organizations are extremely important in the lives of African Christians and Muslims, and they must be included in the AIDS strategy, Green said. “Yes, they might cite Scripture and talk about right and wrong when promoting abstinence and fidelity, but hey, it’s hard to argue with success,” he said.
Although progress has been made to bolster prevention efforts in Africa, Onjoro Meassick said she worries that complacency is starting to set in. In fact, the latest preliminary findings of a Ugandan government survey released in May show a slight upturn in HIV prevalence — from 6.2 percent to 7 percent.
“In the U.S. there is a change of behavior that has led to a plateau,” she said. “There is no reason why the same thing won’t happen in Uganda.”
Christine Casatelli is senior editor at Science & Theology News.
Bush took a swipe at the anti-abstinence crowd in yesterday's pre G-8 speech:
President Discusses G8 Summit, Progress in Africa [Excellent Bush Speech]
And since 2003, our country has undertaken a major effort against HIV/AIDS, the largest health initiative in history to combat a specific disease. Across Africa, we're working with local health officials to expand AIDS testing facilities, to train and support doctors and nurses and counselors, to upgrade clinics and hospitals, to care for children orphaned by AIDS, and to support pastors and priests and others who are teaching young people the values of respect and responsibility and prevention. We're making life-giving treatment possible for more than 230,000 adults and children in Africa. We're determined to reach our five-year goal of treating two million. (Applause.)This effort is succeeding because America is providing resources and Africans are providing leadership. Local health officials set the strategy and we're supporting them. We're also respecting the values and traditions of Africa. Uganda and other nations are applying a prevention strategy called ABC -- Abstinence, Be faithful in marriage, and Condoms. ABC is balanced, effective, and reflects the moral teachings of African cultures. And no one is helped when outsiders try to impose a lower standard of responsibility. (Applause.)
This from the folks who gave us cultural relativism...
The simple fact of the matter is that abstinence works, it works well, and it works better than any other method, period the end.
And Western free love, sodomy, and acceptance of unlimited sexual debauchery has worked so well to stop the spread of AIDS here? AIDS is the only disease I know that is fatal, hip to catch in some circles, and has it's own lobbyists. Don't want to catch an STD? Then use ABC.
Get a clue. Don't go in through the out door.
;)
Cheers.
This article is a real piece of work.
Somehow, it is the conservative Christians' fault that the Africans are having sex with babies, animals, multiple wives and partners, and homosexuals, and spreading AIDS at a rapid rate-- imagine!!! We just can't UNDERSTAND their "morality", that's all it is... after all, we can't go over there and say they are "wrong", now can we????
Well I say, good, fine, let's take all the Christian missionaries, doctors, medical clinics, hospitals, airplanes, tractors and vehicles, and don't forget money, that belong to Christians or Christian organizations in Europe or America and see how much faster this Dark Continent dies from disease, starvation, AIDS, Muslim genocide, native genocide, or whatever else.
This continent needs MORE Christianity, not LESS!!!!
For some reason he seems to think this is a bad thing.
Oh BTW Christians tend to be more pro-sex than anyone else. We really, really enjoy it. The problem they have is that we restrain ourselves to only enjoy sex within the bounds of marriage.
I think those cultures have been promiscious for generations. Before AIDS, it was no big deal.
That's my take.
May your fountain be blessed,
and may you rejoice in the wife of your youth.
A loving doe, a graceful deer—
may her breasts satisfy you always,
may you ever be captivated by her love.
Why be captivated, my son, by an adulteress?
Why embrace the bosom of another man's wife?
Proverbs 5:18-20
Marriage is honourable in all, and the bed undefiled: but whoremongers and adulterers God will judge.
Hebrews 13:4
"And if wearing a bunch of skimpy lingerie from Victoria's Secret turns their crank, then it can only be a good thing for their relationship."
Great post! Just check the number of children at an Evangelical church. Whole lot of multiplying going on there.
later read/ping?
Moral Absolutes Ping.
Yup, abstinence - it works every time it's tried. And if you try it over and over, it keeps working. Never wears out, and it doesn't cost any money.
Odd that anyone would argue about it.
Freepmail me if you want on/off this pinglist.
No one ever caught a fatal disease from being abstinent. Think about it.
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