I think it’s very important to write ALL our Congressmen, perhaps including this little dialogue I just made up just to make sure they can’t miss our point and think we’re advocating a change because of ideology rather than logic, and ask them to ch…

It is all so demoralizing.

Well I’m an expat in Cambodia where the two most common modes of transmission are husband to wife and mother to child. It is estimated that 90% of the men in this country go to prostitutes. It’s accepted and perfectly normal – it’s not something they try to hide in mixed company or anything like that.

I can tell you the situation in the Philippines isn’t that much better. I spent a few years there, among other things working with local organizations on HIV awareness, and husbands going to prostitutes is widespread. Especially husbands who work away from the family for any length of time. And the majority of women in the Philippines who catch HIV catch it from their own husbands, which isn’t really surprising.

Teaching abstinence or monogamy only doesn’t help the problem at all, especially given the social situation where an unfaithful woman’s viewed with far more condemnation than an unfaithful man (she’s not considered to have a need for sex that must be satisfied somehow). Telling a woman to be monogamous isn’t going to protect her or reduce her risks that much, and abstinence isn’t a practical option for every woman everywhere, especially not for her entire life. Condoms, when accurate information is available about them, they can be bought in reasonably non-shaming circumstances (as in a woman can get them at the local pharmacy without the clerk assuming, and telling all the neighbors she’s having an affair), they’re afforably priced, and women haven’t been scared away from them by the Catholic Church*, are fairly effective. As is linking decriminalization of prostitution to STD testing, although legalization would have far more benefit in encouraging testing and ensuring participants were consenting adults (anyone who might consider going to a prostitute but feels ethically bound to make sure she’s a consenting adult, DO NOT hire virtually any prostitute you can find in the Philippines even if she smiles and says she’s eighteen and says no one’s forcing her, because there’s a good chance she was threatened into lying).

ABC is better than nothing in a lot of places because people don’t know the basic facts (part of the reason for the country’s low rate of known HIV infections is that many health care workers don’t understand how HIV works and don’t think that someone who obviously has a non-HIV related disease can have HIV). But any attempt to teach about HIV prevention has to ge beyond the neat little presumption that abstinence is a simple choice you can make where the only downside is going without sex, or that monogamy is simply you decide to be monogamous, you get your partner to agree, and you’re safe forever, which dominates too much of the ABC-approach educational material.

*I will confine myself to respectfully disagreeing with the Catholic Church’s moral stance on condom use the day I see an agressive worldwide effort by the church to prevent HIV by fighting marital infidelity (particularly among men), sexual abuse and exploitation of teenagers, double standards that allow Catholic men to pay lip service to fidelity and sexual restraint while having affairs and patronizing prostitutes, and all other things considered sinful that actively spread HIV, and do so on a larger scale than they attempt to condemn and fight condom use, the “sin” that saves lives. Until that happens, I am going to call the church’s stance as I see it, an irrational double standard that panders to humanity’s baser instincts (it’s easier to focus on the obvious, superficial, and new-therefore-shocking symbols of human promiscuity than to dig into matters that have been running under the surface of society, which society has been structured for centuries to accept). I understand individual Catholics may, and frequently do have different stances than official Church policy, and don’t intend to accuse you all of holding the Vatican’s point of view.

A recent report from UNAIDS shows that condom promotion is so successful with the official sex workers that many men are now going to bar girls and indirect sex workers so they can have sex without condoms.

The ABC “method” is beyond ridiculous in this country and in most I imagine. Wives cannot say no or ask there husbands to wear a condom.

Lets hope for some pragmatism soon!