AIDS in Africa - scratching the surface

The various comments that I and others have been making over at Online Opinion, in response to an essay criticising the Catholic church’s pronouncements against condoms, have generated some heat from the opposition, but there’s one issue they’ve raised that’s worth investigating more fully, and that is the claim that those countries which have practised abstinence according to the Catholic church’s dictates have been far more successful in reducing AIDS than those which have emphasised condom use. Here are some of the claims in the critics’ own words:

Before condemning the catholic position on contraception, how about checking the AIDS facts with the catholic countries in Africa. the countries with the lowest AIDS rates are the ones that use the ABC method advocating abstinence before marriage and faithfulness after.
These countries have high percentage of catholics and low rates of AIDS. The highest AIDS countries are the ones with low catholic numbers and high condom use (condoms aren't 100 per cent effective).
I am not a catholic (or christian of any denomination) and happily use condoms but for people who are and live in Africa - abstinence and monogamy are obviously the safest option.
the usual suspect

Atheists grossly overestimate the importance of the popes utterances in the Lives of most practicing Catholics.
I must be a bit simpleminded but why the hell would a African rooting around give a brass razoo about what the pope thinks about contraception. The man/woman who has premarital sex, commits adultery, has multiple sexual partners is not suddenly going to say I have broken most of the Catholic sexual commandments but I will keep the one about not putting a rubber on. Its this type of thinking that gives atheists a bad name. Sharpen up.
slumlord

And Luigi, have a look at the individual countries in Africa.
Not all African nations are largely Catholic.
The countries which have advocated abstinence (like Uganda) have cut their AIDs rate by up to 500 per cent, while those where there are millions of condoms distributed have seen their rates increase.
I think the Catholic Church has done some pretty horrible things in the past but they have also done good.
Abstinence before marriage and faithfulness in it is the most effective way to reduce AIDS in those countries and it has worked. ABC even promotes the use of condoms as a last resort but many people are willing to abstain. Muslim leaders are also heavily promoting abstinence because they say condom use only promotes promiscuity and they are not 100 per cent safe.
There is an article in last December's Lancet medical journal showing the benefits of the ABC approach - I hope it is a prestigious enough publication for you to not immediately dismiss.
the usual suspect

I’m probably coming across as a pompous wanker. I don’t want to imply that all the Catholics working on the ground in Africa are meddlesome fools, though if they’re of the clergy they’d have to toe the line and condemn the use of ‘murderous’ condoms. Nor do I wish to deny the claim that promoting abstinence is very effective. I’m sure that when AIDS was rife among homosexuals in the West, the immediate response would have been a general reduction in sexual activity, and especially in sex with multiple partners, and it makes sense to encourage this as a short term measure in Africa. I’m all for saving lives first and foremost. There’s a difficulty though when those who would preach abstinence as a good in itself, for religious reasons, are able to point to the efficacy of their religious stand. It really does muddy the waters, and can lead to claims that God is punishing promiscuity, homosexuality, etc, and that their view is the correct one and should be imposed on all.
The situation in Uganda has it seems been widely touted as a success story, though there are a few complicating factors. According to this site, the government claims a reduction in the prevalence of AIDS from above 30% in the early nineties to 4.3% in 2001. The UN has said that only 4.1% had the virus at the end of 2003. However, these figures have been disputed of late. A non-governmental organisation released a study last year which found that the prevalence was more like 17%. This study has in turn been disputed, though many observers believe that the government’s figures are inaccurate. However, there’s no doubt that the prevalence rate is decreasing, against the trend elsewhere in Africa. The ABC method (Abstinence, Be faithful, use a Condom) is a three-pronged attack which is yielding positive results. Most experts on the ground agree that it’s the Be faithful message, spruiked by the nation’s President in tours of the country, that is biting hardest.
Apparently, Uganda has received huge financial support from the Bush administration, funds channelled through faith-based organisations. My concern is that, with this assistance, such Bush-backed organisations will be keen to spread certain moral and religious views along with medical assistance and advice. AIDS is a medical health problem and only secondarily a moral problem. Of course the immorality comes in when someone knowingly exposes others to risks. If on the other hand people are infecting others unknowingly, the responsibility falls on those whose duty it should be to inform the population fully of those risks. It’s about providing full information about preventive measures (and the ABC approach sounds fine to me, as long as it saves lives), the best possible treatment, and if necessary, the enacting of laws to punish those who deliberately put others at risk.
The OLO article, though, deals with the culpability of the Catholic hierarchy and the new pope in being willing to sacrifice lives by thundering against the use of 'abortifacient' condoms and the 'holocaust' they're responsible for.
The philosopher A C Grayling puts Ratzinger's moral equivalence into perspective:

.. the prospect of alleviating suffering is too intrinsically good to be sacrificed to the mistaken view that a cluster of cells... is the moral equivalent of a baby in a crib. The argument that the two are equivalent because the former could in the right circumstances become the latter fails on the grounds that this makes any arbitrarily chosen pair of a single sperm (say in a testicle in Toronto) and ovum (say in a pelvis in Prague) morally equivalent to a baby, for they too in the right circumstances could become one.
Of course, a line has to be drawn. But to draw it at the moment a zygote is formed rather than at the point where a fetus becomes independently viable – from where something really can be ‘become a baby’ – is to ignore the fact that nature itself is profligate with the zygote, the morula, the blastocyst, the embryo, the fetus, voiding itself of any it is not satisfied with, in numbers unimaginable to the moral sentimentalist for whom the mere existence of life rather than its value – its quantity, not quality – is what matters most.

From New Scientist, April 9, p17.