The Condom Controversy: religious fundamentalism and the fight against AIDS in Zambia

It was my first time to visit rural Zambia. As our crowded SUV entered the dusty city limits of the fishing village Mwandi, we were greeted by a large black and white sign, reading: “Welcome to Mwandi, we are concerned about AIDS.” Below were listed the ABCs, “Abstain, Be faithful, Condomise,” and in red letters, “D – or you will die.” It was quite a sobering welcome banner; but it was descriptive of the ideologies about how to fight AIDS which I discovered during my stay in Mwandi.
The incidence of AIDS in Zambia is staggering. According to the 2006 Global Report on the AIDS Epidemic, nearly twenty percent of the Zambian population has AIDS. It is a disease strongly associated with dire poverty, affecting more women than men across sub-Sahara Africa. Nearly half of the population in Zambia is less than fifteen years old, and there are an estimated 710,000 AIDS orphans, evidence of the crippling effects AIDS can have on a poor nation.
In Zambia, like most of sub-Sahara Africa, HIV is largely transmitted through unprotected heterosexual sex. Most non-sexually transmitted HIV results from mother-to-child transmission during child birth or breast-feeding.
Prevention of HIV is the single most effective weapon in the fight against AIDS. UNAIDS projects that treatment combined with prevention will avert 29 million new HIV infections worldwide by 2020, as opposed to only nine million with treatment alone. The UNAIDS protocol for HIV prevention calls for a combination of: abstinence, monogamy, reduction in the number of sexual partners, and correct and consistent condom use. The male condom is still a vital prevention strategy as it reduces the risk of HIV sexual transmission by eighty to ninety percent.
However, promotion of the condom as an AIDS prevention strategy has encountered resistance from some governments and religious groups. Traditionally, Christian fundamentalist groups focus on the abstinence and fidelity aspects of AIDS prevention but refuse to incorporate condoms. For example, in 2001 the Christian Council of Zambia was successful in removing condom advertisements from the radio, claiming they encouraged promiscuity. President Chilumba, who declared Zambia a Christian nation in 1991 and who said condoms were a sign of lax morals, supported the clergy in removing the condom ads as did the Minister of Education (AEGIS). Also, the Catholic Church widely rejects the use of contraception. In fact, at a 2005 meeting with African bishops, the Pope warned that “contraception was one of a host of trends contributing to a ‘breakdown in sexual morality’, and church teachings should not be ignored” (BBC news, 2005).
The condom controversy surfaces in areas where religious non-governmental organizations (NGOs) must create health policy due to lack of government involvement. Because most African countries do not have sufficient public health infrastructure, many nations rely on NGOs for health services, especially in rural areas. When religiously-funded organizations are charged with overseeing health policy, they may encounter a moral conflict. On one hand, they must comply with recommendations from the World Health Organization and UNAIDS to incorporate condoms in HIV prevention in order to save lives. On the other hand, they must appease the church by omitting condoms from HIV prevention strategies, which the statistics indicate will lead to more deaths from AIDS.
The condom controversy raises important questions as to the role of NGO involvement in health policy when NGOs are limited by their supporters of the religious right. Are they doing more harm than good in fighting the AIDS pandemic? Fortunately, condom distribution is now possible for some church-sponsored health clinics, which previously did not distribute condoms. For example, a July 2005 issue of Christian Century offers encouraging news about the condom controversy in Zambia. It claims that the Zambian Council of Churches “would promote the use of condoms only to prevent the further spread of disease.” The General Secretary and other bishops admitted, “If we don’t encourage this, we will be blamed for not saving lives” (Dart 2005).
Hopefully such tolerant attitudes will become prevalent among faith-based NGOs in the near future. If not, the consequences for the rural Zambian public could be devastating. Whereas there are many compounding factors in the solving the AIDS problem, adhering to the simple ABCs of AIDS prevention is certainly a good place to start.

Thanks for listening, I’m Wes Fiser

Bibliography
Dart, John. “The Council of Churches in Zambia is supporting the use of condoms in the fight against HIV/AIDS.” 26 July 2005. Christian Century 122(15):17.
“Pope Rejects Condoms for Africa.” 10 June 2005. BBC news. 21 October 2006. .
UNAIDS. Comprehensive HIV prevention. 2006 Report on the Global AIDS Epidemic. 2006. 14-50, 124-128.
“ZAMBIA-AIDS: Condom adverts deemed too explicit: ‘Condoms are one of the major ways of preventing the spread of AIDS.’” 12 January 2001.UN Integrated Regional Information Network. AEGIS. 22 October 2006. .

The Correlation Between Gender-Based Violence and HIV/AIDS

In sub-Saharan Africa, an average of three women are infected for every two men. Among young people aged 15-24, that ratio widens substantially to three women for every one man. This disproportionate impact of the AIDS epidemic on women reflects the conditions of social and economic inequality in which they live. Violence is one of the crucial social mechanisms by which women are forced into a subordinate position in which it is difficult, if not impossible, to protect themselves from HIV.
The correlation between gender-based violence and HIV/AIDS involves a combination of biological, social, and cultural conditions. Women are already at least twice as likely as men to contract HIV from unprotected sex, in part because semen carries more HIV than vaginal secretions. Violent sex and rape increase a woman's biological vulnerability to HIV by causing bleeding and tearing of the genital area, creating passageways for HIV to enter the bloodstream. Conversations about safer sex, HIV status, or HIV risk reduction are highly unlikely in rape situations, and condoms are not generally used. Many victims of sexual violence develop alcohol and/or drug dependency, depression, low self-esteem and post-traumatic stress disorder, which can in turn lead to multiple partners, unprotected sex or increased risk taking.
Violence between intimate partners is another consequence of gender inequality. Studies show that up to 50% of all women worldwide report being physically abused by an intimate partner. Physical violence between intimates contributes to HIV transmission by harming the ability of partners to communicate openly with each other. A woman is less likely to discuss HIV status or insist on the use of condoms when she is afraid of violent retaliation by her partner. The constant threat of violence makes women feel vulnerable and allows men to maintain control over the decision of when and how to have sex.
Gender-based violence also occurs as a result of HIV infection. Popular misconceptions about HIV, such as the belief that sex with a virgin can cure infection, lead to acts of rape and sexual violence. Being HIV-positive is a serious risk factor for violence against women. Many women who reveal their HIV status to partners, family members, and communities are in danger of being physically and emotionally abused. Sex workers also experience an increase in violence from clients who blame them for contracting HIV.
As the correlation between HIV and gender-based violence becomes increasingly apparent, urgent efforts are needed to combat the growing rates of infection among women. Laws and policies that protect against sexual violence and gender discrimination of all kinds must be enacted, publicized and enforced. Gender-based discrimination prevents women from making free and autonomous decisions, particularly with regards to sexuality and relationships. So long as women's human rights and dignity are not respected, sexual violence will continue to increase women's vulnerability to HIV and fuel the impact of the AIDS epidemic.

Product(RED): Raising funds for the Global Fund

What do Converse, Gap, Apple, and Motorola have in common? They all are partners in (RED), an initiative designed to raise money for the Global Fund to Fight AIDS, Tuberculosis, and Malaria. And today, October 13, 2006, marks the official launch of (RED) in the United States.

Founded by U2 lead singer Bono and Bobby Shriver, Chairman of DATA in early 2006, (RED) has enlisted several corporate sponsors, most notably the companies listed earlier. Each of these companies has designed one or more special (RED) products. A portion of the profits from the sales of these products will go to the Global Fund. More information about (RED) can be found at www.joinred.com.

So as of today, you can purchase a Product (RED) t-shirt at the Gap, Product (RED) Chuck Taylors from Converse, a Product (RED) iPOD nano from Apple, and a Product (RED) RAZR phone from Motorola. Not only will you have some pretty cool accessories, but you also will be contributing to the fight against HIV/AIDS and showing your support for this worthy cause.

Why should we do this? The (RED) Manifesto states it clearly and succinctly: “As first world consumers, we have tremendous power. What we collectively decide to buy, or not to buy, can change the course of life and history on this planet.” I hope you choose to buy (RED).