Delegates at the XVI international AIDS conference held in Toronto last week heard in a packed debate how a HIV prevention strategy that relies on abstinence and fidelity is fuelling the HIV epidemic in sub-Saharan Africa.
During the heated debate, ‘ABC in Africa – What is the Evidence?’, held on the last full day of the AIDS conference, activists warned that such a strategy only reinforces gender inequalities, making women more vulnerable to the virus.
ABC stands for Abstain, Be faithful and use a Condom and is a prevention programme which has been credited with reducing the rate of HIV infection in Uganda.
But development agency Christian Aid has criticised ABC as being too dogmatic and simplistic, arguing that human sexuality is too complex for the tight categorisations of ABC programme.
Christian Aid has introduced a new prevention approach to the HIV pandemic called SAVE – Safer practices, Available medication, Voluntary counselling and testing and Empowerment.
Beatrice Ware is a well-known HIV activist from Uganda who contracted the virus in marriage, like a number of women, despite abstaining from sex until marriage and remaining faithful to her husband.
“If ABC did work why is it that, after 25 years of HIV, we still seeing an increasing number of women being infected?” she challenged.
Ware says that ABS is unrealistic and that it assumes that women can choose to abstain and when they choose to remain faithful, that their partner will be faithful.
“It does not take into account that in most developing countries power resides with men. ABC ignores the powerlessness of women; most women cannot decide when, where and how to have sex.”
“This issue of gender inequality is extremely important,” concurs Dr Rachel Baggaley, the head of Christian Aid’s HIV Unit. “We are still stuck with HIV prevention methods which rely on men making decisions.
“Women will remain vulnerable as long as there are no protection methods which they control. We still do not have women in key political positions who are prepared to take on the issue of male domination.”
“ABC stigmatises HIV positive women,” continues Beatrice Ware. “It allows people to conclude that we are either promiscuous or unfaithful.”