“Know your status” was a paid-for advert on many South African Radio Stations at the end of 2012. I have been tested about 5 times. I know my HIV status. But what of SA’s HIV status? Edward Green added the following pragraph:
Also, how does “Know your status” reduce the rate of HIV infections? In fact, it has been shown in Africa that it does not. Most people (yes, even in RSA) test negative, and a careful, prospective study in Zimbabwe shows that testing HIV negative tends to relax people’s behaviour—disinhibit behaviour, they say in public health. And disinhibited behaviour is not what we need in RSA. We need more careful and restrained sexual behaviour. Condom use also disinhibits behaviour. This helps explain why countries with higher condom user rates (e.g. RSA, Botswana) have higher HIV infection rates and countries that have lower condom use have lower infection rates (e.g. Ethiopia, Rwanda).
There are a number of ways we can measure the HIV status of a community. Prevalence is the percentage of the population that has HIV. Currently (2013) South Africa’s HIV prevalence is about 12% of a population of 50 million. This means that 6 million people in South Africa have HIV. This is more than any other country in the world.
A much more useful measure is the incidence of HIV. This is the rate of new infections every year, which is much harder to measure. The way this is measured in South Africa is by taking the number of first-time pregnant mothers that have HIV compared to those who do not. In 2011incidence was 30%. (I have been unable to get official figures for 2012 and 2013 but estimates are 35% and 40% respectively.) Edward Green who used a different unit to measure incidence showed in a Unganda city a drop of 70% in HIV infections between 1990 to 1998. This is his comment: Incidence in Masaka (Uganda) fell from 7.6 per thousand per year in 1990 to 3.2 per thousand per year by 1998
Deep down each of us know that “unfaithfulness is wrong”. Research has show that “sex within the boundaries of a faithful loving relationship is more frequent and much more satisfying than casual sex”. Put more strongly, if no one had an additional partner, but instead kept to one partner at a time with about a month waiting time between new partners, there would be no AIDS epidemic! The Pretoria News carried an article with the title Risky Business in which it said, “There is an association between casual sex and mental health among emerging adults”. Why in the FPD’s HIV Testing and Counselling course I did was there no mention of any of these facts?
Public health in SA assumes that increased condom use will reduce the chances of pregnancies, HIV and other STIs. No good scientific research has shown this to be true in Africa. Promoting condom use and giving away condoms for free increases the number of new HIV infections. (See Studies in Family Planning 2013; 44: 25–43.) In addition, condoms do not protect our spirits, our emotions or our mind from being damaged by casual sex.
Why is South Africa so very, very ill in terms of HIV? We have believed lies. We have avoided the truth. The main lie is “as long as you use a condom and know your status you are safe”. The truth that we need to take hold of is “the only safe sex is sex within a committed faithful relationship”. Sex was created by God, it is good and wonderful and a delight inside a loving, faithful relationship. Healthy sex (this means sex that is within boundaries of loving faithfulness) can contribute to strong family ties, happy communities and a healthy society.
In the thick HIV Counselling and Testing manual of about 400 pages there is not a word about cultural norms, morality relating to sex or religious understanding. On page 91 there is a paragraph on ‘free grazing’:
In many of the Southern African cultures ‘free grazing’ is considered the norm for young, unmarried males. By free grazing it is meant that the male is permitted to enjoy sexual intercourse with females without commitment to marriage. The practice of free grazing is a perfectly normal biological behaviour pattern. This is seen in all living animals and is again a primal method in ensuring the survival of the species.
Note that this is the direct opposite of Uganda’s highly successful “Zero Grazing” policy and program, which is the main reason HIV prevalence fell by two-thirds before the mid-2000s. The powerful major donors did not support Zero Grazing, and instead pushed hard for the Uganda government to accept the condoms-testing-drugs formula. HIV prevalence in Uganda has risen again, as an apparent result of the unfortunate policy shift
The main approach to prevention that is being used in South Africa today is failing to deliver. The more money that is ploughed into the prevention of HIV the greater the growth of HIV, because prevention is based on American and European prevention formulas that have not worked well even there, e.g., in the US or the UK. The Western Cape and Northern Cape have the lowest condom use and the lowest HIV … they go hand in hand.
The story of how Uganda reduced the prevalence of HIV by two thirds from about 1988 to 2000 is told in a book by Edward Green Broken Promises. It is well written and he clearly shows that it was not the condom message that turned HIV around but a message “Love faithfully” (and this would be a catch-all for promoting faithfulness at every level of relationships and discouraging concurrent multiple sexual relations (like free grazing). It was promoted by FBOs, Politicians, the Press, TV and the Radio. I hope South Africa, indeed all of Southern Africa, can adopt an approach like Uganda’s before Western interference. A small step in this direction is the One Love program. (See Studies in Family Planning 2013; 44: 25–43.)
The apostle Paul wrote most of the New Testament. He has had an undeniably positive impact on cultures in the world. In 1 Corinthians chapter 6 v 18 he writes:
Flee from sexual immorality. Every other sin a person commits is outside the body, but the sexually immoral person sins against his own body.
In the excellent Islamic course on prevention of HIV and other STIs I did it was pointed out:
- HIV is a choice
- HIV is an optional disease