sorry TIME, but i have to disagree. the reversal in Uganda is consistent with the change in President Museveni (and his wife)'s attitudes toward condom use, which have been seriously and severely influenced by George Bush's PEPFAR policies. Before 2004, Museveni and the First Lady encouraged the ABC's of HIV prevention (abstinence, be faithful, wear condoms) publicly and openly, and Uganda's massive reduction in HIV rates were attributed to their proactive attitudes and (relative) openness. Since 2004, when Bush implemented his caveats to PEPFAR funding, Museveni has come out publicly encouraging the adherence only to A & B and abstinence until marriage.
as for female condoms, I studied in Kampala, Uganda last summer and my final project involved surveying citizens both in the city and a more rural region (Kakiri) about their attitudes toward condom use. the responses to our questions regarding female condoms can be summed up as the following: if they had heard of female condoms, they heard that they were not reliable and broke. most surveyed had not heard of female condoms and, after a brief description of fc's benefits, were unwilling to consider ever trying them.
It's about diligence. It's hard to force the condom issue into spotlight when you're in a relationship, whether purely sexual or otherwise. Suggesting wearing a condom has implications of one or the other partner is "dirty" or "whorey" when it's really about protecting both partners from the possibilities. Unless you are in a committed relationship with open communication and knowledge of STD status, it's frightening. And the committed relationship is not infallible - the what ifs need to be discussed. If there is an instance of cheating, please for the protection of everyone involved, make sure a condom is worn.
But talking about all of this in the moment is a mood killer. Talking about all of this in a relationship makes you seem like a pessimist. I speak from experience and I've backed down on the condom issue when I shouldn't have, with people I've trusted but when the situation was casual. Even though it hasn't resulted in any negative aspects for my health, I can't assume this will always be true and I've resolved to be more adamant in the future. But maybe some people never get the chance to do that - maybe that mistake has already been made with the consequences of AIDS. And in countries where sanitary napkins and soap are traded for sex, the chance of open dialogue regarding sex and sexual health seems slim.
Condoms, combined with massive campaigns to get people to use them. That is, of course, the hardest part (getting people to use them) - one only has to look at how many people in the US don't to understand how difficult it is to get those in more male dominated societies to get on board.
@mama_t: I love how people in the US assume that marriage will protect them from all STDs and then make the claim that people in developing countries "need to be educated."
It's a huge pet peeve of mine. These are beliefs that are deeply ingrained in....well, all of us, really.
The first step to better HIV prevention is to avoid anthropomorphizing condoms into terrifying, mute, caped ghosts/KKK members who are dead set on getting in your vag. Stay away from my ladyparts, scary cartoon condom!
Has anyone else here but me ever tried the female condom? the thing is awful, uncomfortable, awkward, and unsightly. I personally believe it would make infection rates skyrocket because after the frustration of trying to use one of those things more people would say 'fuck it!' and go in skins. And since it is so tricky I would say the female condom requires almost MORE cooperation from a male partner than a regular condom to use correctly, so I don't see how this would empower women to demand safe sex from unwilling partners.
I'd also be interested in hearing how funding filters into Africa for HIV/sexual health--is it mostly government, private or religious organizations? Is there are uniform and strong message of abstinence? Do religious organizations often fail to make condoms available?
HIV prevention has a set of ABCs: Abstinence, Be faithful, Condoms.
I know why people focus on the condoms angle, its the easiest behavior to change. But it bothers me that there are so few campaigns that focus on the Be Faithful part. Married women are at risk for HIV not because they're out sleeping around, but their husbands are. But very few campaigns target men and say "When you visit sex workers, you aren't just risking your own health, you are risking the health of your wife/partner and unborn children. Be a man, protect your family, be faithful."
Condoms are the faster pitch, you don't have to wait for culture to change. But the rate of HIV in some countries means that even with perfect condom use, the infection will spread.
@clevernamehere: It's not a pitch. I have a close friend who contracted HIV from a longtime partner with whom he thought was faithful. Being faithful sounds great, but if we're talking about women in danger, I would rather they have a protection that can see, not just hope that their partner will not have sex with others.
Culture change is important, but many, many more people are at risk until that happens.
@Penny: I'm not saying people should just cross their fingers that their partner is faithful, but we're not talking about US style infidelity. Men stepping down how often they visit sex workers or have other extra-marital sex could make a big impact.
@Penny: Also notice the Time article says that foriegn NGOs pushing local Ugandan programs away from monogomy campaigns is considered a possible cause of the upswing in infections.
@clevernamehere: I know you're not, I just think it's incorrect to label condoms as a "pitch." It's an important element. And I agree that these overarching (human) problems need to be addressed, but it will just take such a long time.
@Penny: There are so many people working on condom programs and in some countries they've been really successful. But I'm not convinced that more condom programs will help countries that have had 15 years of them and still have a high rate of new infections.
It is particularly troubling that LOCAL programs were pushed to shift focus, even though Ugandan programs probably know more about Uganda.
In a word, more access to male condoms. I know it seems simplistic, and I am all for empowering women to protect themselves, but not if it's so unappealing that few will make that choice. More access is the first step, education is the second, and it will take a long time for the cultural shifts to occur. But, the more women who are empowered to say "not without a condom" the better.
Condoms are not 100%, but I think we can all agree that abstinence will not happen and people are not always monogamous. And I'm not just talking about Africa.
I thought it was established that circumcision only had minimal positive results, even for men?
@Penny: Minimal positive results in countries where 30% of the people have HIV (99.9% of whom don't have access to antivirals) isn't that minimal. There are all kinds of other problems with those studies- like the fact that you're just waiting around for people to get HIV, how do you get men circumcised and how will getting cut to prevent HIV effect condom usage.
I love magazines, from Harper's to tabloid trash. What the hell else am I supposed to read in the bath or on a short-haul flight? a book? Get bent! I really do love them, though.
I'm so over magazines, but that may be partly because I worked as an editor for 15 years. The only one I find worth reading these days is the New Yorker.
I get some magazines. I get Fitness, Women's Health, Cooking Light, Gourmet, Food & Wine, Fair, Allure, and Lucky. I wish I could stop Allure and Lucky but they auto-renewed them before I could stop them. *sigh* I want to start getting Oxygen or Muscle & Fitness Hers. I like the exercises to make you strong, not just toned.
I actually started to subscribe to magazines once the economy took a nosedive because of the break you get off the newstand price. I really enjoy spending my Wednesday with Sports Illustrated and my Friday with Entertainment Weekly (although the quality of that mag has dropped significantly).
The one thing I found is that I'm actually less likely to read a monthly mag in a timely fashion when I subscribe then when I get it on the newstand. I haven't opened a Vogue in months even though it keeps showing up (I really need to ask Conde Nast to switch my subscription to the New Yorker or something, maybe extend Vanity Fair).
But I hope not too many more mags fold. What will I do on long plane trips without a good glossy?
08/31/09
sorry TIME, but i have to disagree. the reversal in Uganda is consistent with the change in President Museveni (and his wife)'s attitudes toward condom use, which have been seriously and severely influenced by George Bush's PEPFAR policies. Before 2004, Museveni and the First Lady encouraged the ABC's of HIV prevention (abstinence, be faithful, wear condoms) publicly and openly, and Uganda's massive reduction in HIV rates were attributed to their proactive attitudes and (relative) openness. Since 2004, when Bush implemented his caveats to PEPFAR funding, Museveni has come out publicly encouraging the adherence only to A & B and abstinence until marriage.
as for female condoms, I studied in Kampala, Uganda last summer and my final project involved surveying citizens both in the city and a more rural region (Kakiri) about their attitudes toward condom use. the responses to our questions regarding female condoms can be summed up as the following: if they had heard of female condoms, they heard that they were not reliable and broke. most surveyed had not heard of female condoms and, after a brief description of fc's benefits, were unwilling to consider ever trying them.
08/31/09
But talking about all of this in the moment is a mood killer. Talking about all of this in a relationship makes you seem like a pessimist. I speak from experience and I've backed down on the condom issue when I shouldn't have, with people I've trusted but when the situation was casual. Even though it hasn't resulted in any negative aspects for my health, I can't assume this will always be true and I've resolved to be more adamant in the future. But maybe some people never get the chance to do that - maybe that mistake has already been made with the consequences of AIDS. And in countries where sanitary napkins and soap are traded for sex, the chance of open dialogue regarding sex and sexual health seems slim.
08/31/09
But use of protection is key in this fight.
08/31/09
It's a huge pet peeve of mine. These are beliefs that are deeply ingrained in....well, all of us, really.
08/31/09
08/31/09
08/31/09
08/31/09
08/31/09
08/31/09
I know why people focus on the condoms angle, its the easiest behavior to change. But it bothers me that there are so few campaigns that focus on the Be Faithful part. Married women are at risk for HIV not because they're out sleeping around, but their husbands are. But very few campaigns target men and say "When you visit sex workers, you aren't just risking your own health, you are risking the health of your wife/partner and unborn children. Be a man, protect your family, be faithful."
Condoms are the faster pitch, you don't have to wait for culture to change. But the rate of HIV in some countries means that even with perfect condom use, the infection will spread.
08/31/09
Culture change is important, but many, many more people are at risk until that happens.
08/31/09
08/31/09
08/31/09
08/31/09
It is particularly troubling that LOCAL programs were pushed to shift focus, even though Ugandan programs probably know more about Uganda.
08/31/09
Condoms are not 100%, but I think we can all agree that abstinence will not happen and people are not always monogamous. And I'm not just talking about Africa.
I thought it was established that circumcision only had minimal positive results, even for men?
08/31/09
08/31/09
08/31/09
I don't think its a feasible plan to fight HIV, but its hard to tell what would happen if it was feasible.
04/03/09
04/03/09
04/03/09
Yit-ta-dee!
Happy dance!
04/03/09
04/03/09
04/03/09
(and I quote)
But seriously glossy mags are one of my vices. Please dont die.
04/03/09
The one thing I found is that I'm actually less likely to read a monthly mag in a timely fashion when I subscribe then when I get it on the newstand. I haven't opened a Vogue in months even though it keeps showing up (I really need to ask Conde Nast to switch my subscription to the New Yorker or something, maybe extend Vanity Fair).
But I hope not too many more mags fold. What will I do on long plane trips without a good glossy?