What's The Best Way To Combat HIV/AIDS Around The World?S

Female condoms and circumcision are two of the options being weighed in light of new research and news coming from the country of Uganda, but experts disagree on their ultimate impact in fighting the disease.

Uganda is attempting to stem the growing epidemic by offering more options for women to protect themselves. Research showed that women were highly at risk for new infections (and can pass these infections on to their offspring through childbirth, so new initiatives were explored. Heading up the renewed push is a female condom program, but it has already encountered some significant stumbling blocks.

With funding so limited, many donors argue, why invest in an expensive product that faces deep skepticism from the people who would use it? Female condoms, originally introduced in the early 1990s, have struggled to gain widespread acceptance because they are more expensive and less familiar than male condoms - they're big and baggy, make rustling noises during sex, and you need instruction and practice to learn how to insert them properly.

But Uganda sees the female condom as one way to regain the success the nation had in the fight against HIV/AIDS in the 1990s. After slashing its AIDS rate from more than 20% in the late '80s to about 6% in 2000, Uganda saw a leveling off of AIDS cases and then a slight rise. No one has been able to explain the reversal. Some say it's related to failed distribution programs for the male condom in the past. Other experts suspect that it's a result of foreign NGOs and governments pushing Uganda away from effective domestic programs that were aimed at keeping people from having more than one sexual partner, a relatively common practice in the country.

Other news from Uganda points to circumcision as an effective deterrent to HIV. The NY Times reports:

[C]ircumcision can make a significant dent in the H.I.V./AIDS crisis in this country is still being debated, because the epidemic in the United States is so different from the one in Africa. The African trials found heterosexual men were less likely to acquire the H.I.V. virus after circumcision, but largely ignored the question of whether women were safer - or possibly put at even greater risk of infection, as one small study suggested - if the man was circumcised; they also focused exclusively on heterosexual transmission, though in the United States, men who have sex with men are at higher risk.

Even Dr. Gray, who led the trials, is not sure the United States should promote circumcision. "If you were to ask me, should the U.S. be promoting circumcision, my answer would be, ‘no,' " he said. "What I do think ought to be the policy is that parents should be informed about the potential protective effects."

Each article hinted at religious and cultural traditions that enabled the spread of HIV/AIDS and the distrust of misuse of condoms, but focused on a lot of the issues between existing solutions. AIDS is still spreading in all corners of the globe and for some reason, despite educational campaigns and the occasional project funding, we seem to be succumbing to the virus.

The Battle In Uganda Over Female Condoms [Time]
The Latest Fight Over the Foreskin [NY Times]
Statistics: Worldwide [AMFAR]