C Stanley McCain's nonresponse was idiotic, of course, but I don't think this comment is fair:

should he try to save thousands, ten thousands, even millions of people or should he say what the social conservative base wants to hear?

You're implying that social conservatives don't want to save millions of people. Bush's current policy, while it might deserve some criticism, combines distribution of condoms with education about abstinence and monogamy. These programs have proven effective and many African governments want to take this approach (in fact if I'm not mistaken, the program was modelled after one developed in Uganda). Condoms do fail so people should always be educated to the fact that only abstinence and faithfulness can fully protect. Also, there's a need to change mindsets in African countries that men are entitled to basically rape women, to not require their consent. The abstinence and monogamy education programs are helping to educate the young men so that women have the right to choose their own sexual activity or to choose to remain abstinent. If we strictly gave money for condom distribution then that wouldn't be happening.

Interested Good example of why he'd never make it to the big chair. You've got to have a non-answer answer to any question your aids do not want you to answer. Which is too bad, I think he'd make a decent President, he just does not have the umph to get elected.

Interested

Also, there’s a need to change mindsets in African countries that men are entitled to basically rape women, to not require their consent.

In addition to that, there is the belief (in some African countries amongst men) that to rid yourself of Aids you need to have sex with x number of young virgin girls. It's a belief that goes way way way back.

mvdg C.S. - what I read about it is that the "abstinence" tactic isn't effective at all. Of course education is a part of it as well, but, like it or not, they will most likely continue to have sex outside of marriage. As far as I understand, condoms have helped a lot. The fact of the matter is that one can choose between trying to establish a Utopian help program, or do something that's actually effective. Lastly: I'm all for a combination - distribute condoms, while at the same time educating them in the way you describe.

mvdg

Good example of why he’d never make it to the big chair. You’ve got to have a non-answer answer to any question your aids do not want you to answer. Which is too bad, I think he’d make a decent President, he just does not have the umph to get elected.

Yes I agree. It's quite a tragedy actually. He, somehow, screws it up time and time again. As I see it, McCain's worst enemy is McCain.

C Stanley

Lastly: I’m all for a combination - distribute condoms, while at the same time educating them in the way you describe.

But that's what Bush's program is doing and it's roundly criticized by the left. While you are obviously not "the left", you say that what you read indicates that abstinence doesn't work. Well, that may be true for pure abstinence programs, but the combination programs DO work. So when you read that it doesn't work, is that point also made or is it implied that it is worthless to concentrate on abstinence/monogamy education at all? To be clear though, I'm not saying Bush's program is perfect. There's some criticism that the condom distribution focuses on prostitutes rather than the general population, and I don't know whether or not that's true but it seems credible that they may be doing that and I'd disagree with it if they are doing so. But I saw an exchange on C-Span with the director of the Africa-HIV program giving a report to a Congressional committee and for every complaint that was levelled at him he had a very cogent response and the Congresscritters responded with stunned silence, almost apologizing for asking the questions when they realized how wrong their assumptions had been.

jpe

Bush’s current policy, while it might deserve some criticism, combines distribution of condoms with education about abstinence and monogamy.

1) I believe this is incorrect. The method that has worked well, and to which you're referring, is the ABC approach (abstinence, be monogamous, condoms). The problem is that Bush's policy is more like ABc, in which condoms play a minimal role, being favored only for those considered high risk, such as prostitutes. The smallness of the "c" is apparent from both the cuts in funding for condoms and the fundy insanity of his global AIDS coordinator. 2) This reminds me of when Frist was courting the religious right and claimed AIDS can be transmitted through sweat. 3) I have no idea why McCain would hem and haw about this; the religious right largely hates him, so it's not like he's going to win any votes by acting stupid.

jpe

So when you read that it doesn’t work, is that point also made or is it implied that it is worthless to concentrate on abstinence/monogamy education at all?

It's a question of emphasis. The ABc model operates by working on the virtue of the subject, and doesn't seem to recognize the cultural and demographic differences ably pointed out above (viz., rape is common, and so many people already have aids that unprotected monogamy is highly dangerous)

mvdg JPE: great explanation. C.S.: why are you strictly talking about Bush, and not about McCain? He was asked whether he believes tax payers money should be used to distribute condoms in Africa. He, McCain, could not answer that question. That's the subject here.

C Stanley

The smallness of the “c” is apparent from both the cuts in funding for condoms and the fundy insanity of his global AIDS coordinator.

Citations to back this up, JPE? I don't know if the guy I saw on CSpan is the same guy you're referring to; if so, the Congressional committee members obviously had that sort of opinion of him at the outset of the meeting but their attitudes visibly changed when they heard his actual report and responses to their questions. MvdG: I brought it around to the Bush program because I read into your comment (perhaps incorrectly?) that you were critical of it. I already agreed with your point about McCain, that was the most ridiculous ducking of a question I've ever seen. But I responded to what you wrote, which implied that the social conservative position isn't an effective approach. Since Bush's policy was obviously a reflection of the preferences of social conservatives, I didn't think it was a leap to assume that you were critical of it. If I was wrong to assume that, then I apologize. JPE, some of what you wrote in comment #8 contradicts facts that I've read; for example, as you rightly point out, the infection rate is high so that unprotected monogamy is not safe, and from what I've read the programs do distribute condoms to protect in those cases. The whole point though is that distributing condoms without the education part is NOT as helpful as doing it as a comprehensive program.

C Stanley And MvdG: What I'm objecting to in that second paragraph of your post is that you set it up as an either/or situation: either McCain should endorse a postion acceptable to the social conservatives OR he would be sentencing millions to death. That's a ridiculous, false dichotomy and it's another reason I brought the current plan into the discussion. It is a policy endorsed by social conservatives and it has led to fewer deaths, not more.

mvdg Okay, well, we disagree on the effect of certain policies perhaps, but it's good of you to point that out.

mvdg Perhaps I should have used "or should he say what he thinks the social conservative base wants to hear?" It seems to be quite clear that he's not willing to say that condoms should be distributed because he's afraid of saying something that'll turn off the 'religious right'. My point is not that what you suggest is bad, my point is that not distributing condoms will cause many, many people to die.

Interested

Bush’s policy is more like ABc, in which condoms play a minimal role, being favored only for those considered high risk, such as prostitutes.

This is where I frown at the left. Rather than saying - hey at least we are trying to target a high-risk population (not a bad target in itself). They instead make statements that make it seem to be - why are we even bothering to pass out one condom at all.

C Stanley

My point is not that what you suggest is bad, my point is that not distributing condoms will cause many, many people to die.

Well, I guess my complaint is that you are suggesting that most social conservatives believe that no condoms should be distributed; this is the way liberals portray it but I don't think that's true. The way I see it, social conservatives understand the need for condom distribution in Africa (I admit, not all of them do, and also that many feel differently about domestic programs vs. Africa). But the opinion is that the condom distribution without all of the other components is not as effective as the comprehensive program. So it is the far left that has the more ridiculous approach IMO, because to some (don't misunderstand, I'm not implying all liberals here, just the extremists on this issue), if you do anything BUT distribute condoms then you are wasting money that could be used to buy more condoms. Interested: good point. I've yet to see a side by side comparison (hehehe...I almost wrote "head to head" and thought better of that phrase in this context) of how much funding is actually going to condom distribution now vs. in the past. My point being, since the overall funding for HIV prevention is massively greater now than it ever has been, it may be that we're distributing more condoms then before but because of the other emphasis people are able to complain as though we're not doing enough in that one area.

domajot My criticism of current policy is not based on the efficacy of abstinence lessons. I ciriticize the denial of funding to local programs that don't adhere to the US guidelines. People are denied condoms and are at greater risk because their administrations don't toe the line on policy. Agree with me or die, is not a defensible position.

Interested Domajot, What is your opinion on the Texas Legislature wanting to overturn Gov. Perry's mandate requiring school age girls to get the HPV vaccine. Of course it's not just in Texas alone, that is however - the most visible case.

Mikef I agree that Uganda's ABC program has been highly effective in combatting AIDS in Africa. But everything I've read, indicates that George Bush only believes in the abstinence and fidelity part of the program. A quick google search seems to support that perception, but if you can point out a counter-argument I'd be glad to see it.

Government Report Faults Limiting AIDS Strategies to Abstinence and Fidelity A government emphasis on sexual abstinence and fidelity programs to fight worldwide AIDS -- approaches that are often advocated and carried out by religious groups -- is undermining other more comprehensive and accepted methods to fight the pandemic, according to a new study by the Government Accountability Office (GAO). But federal officials who administer the AIDS relief programs disagreed with the report, saying the American government's approach includes all elements of prevention, and that the new emphasis on abstinence and fidelity is designed to balance earlier programs that were overly focused on condoms.

http://www.religionandsocialpolicy.org/news/article.cfm?id=4060

domajot Interested- Honestly, I'm not sure about the mandated HPV vaccinations. I'm becoming concerned about drugs being put on the market too soon. The pharma lobby is much too strong, and too many drugs have had to be recalled. In principle, though, I hope something like this will become as routine as vaccinations against polio.

Interested For the record I fully support putting condoms anywhere possible for anyone. (just like I do giving needles to drug users). Educate yes, tell them the horrors of a STD - but in the end, have a basket of condoms sitting there for someone to get one in privacy. Here is an interesting article on the topic. http://www.iwhc.org/resources/gettingreal.cfm

domajot About Uganda one can be sure that the HIV rates are going down. As I keep on railing, it's not a good idea to read too much into a single statistic. A statistic is simply an observation, it can not clearly point to a cause-effect relationship. Other things are going on in Uganda besides ABC. Their compulsory testing program has got to have an impact, for example. Also, there is mounting evidence about rising early death rates affecting the final statistics. HIV infection rates going down looks good, but it's dangerous to use this as a propoganda tool bedore we understand all the factors at play.

jpe

This is where I frown at the left. Rather than saying - hey at least we are trying to target a high-risk population (not a bad target in itself).

Uganda initially meant the C as in condoms for everyone; the US strategy is to limit condom promotion to only "high risk" groups (eg, prostitutes, etc). The problem is that because of the prevalence of AIDS, virtually everyone is high risk. Additionally, a lot of the money is funneled through Christian organizations; if these groups are anything like their US counterparts, they're likely spreading the message that condoms fail, so don't bother with them. (it's fear of this message that led people to get angry when the US Aids bureau stated that condoms were only 80% effective; that could've been a good faith difference over statistical evidence, but the concern is that the stats are manipulated as they routinely are by US faith-based groups like Silver Ring Thing and the like).

I don’t know if the guy I saw on CSpan is the same guy you’re referring to; if so, the Congressional committee members obviously had that sort of opinion of him at the outset

A quick googling suggests I exaggerated his looniness. Consider it provisionally retracted.

Interested your making my point jpe one condom in the entire region is better than none. for the left to make it sound like why do it at all is a dangerous position to take. instead theyd be far more effective at saying - great one condom is good lets go for two. postioning as they do people will think it is zero effectiveness so why bother at all.

domajot Interested - Where do you get the impression that he Left is saying 'why bother'? I suspect that's a total misrepresentation. All I've ever seen is a demand for less restrictions on making condoms available. I've never met your kind of "Left'.

Interested Read the comments domajot, If you haven't met it, it's due to not seeing it I suspect, or probably not reading how others may read it. The left is ready to say whats wrong with a program rather than what's right and how to make it better.

domajot Interested= Actually, I don't care what the Left or Right is saying. My point of reference is the last international conference on HIV/AIDS. (The comments for this post don't really make clear what was said in the cited C-Span telecast.) I have a number of criticisms of US policy in this area, but this is in the hands of the administration, managed by presidential appointees, who oversee the execution and staffing of the program. There is nothing one can do to change and improve, as you say, except to complain and advocate. PS I was just surprised by your comment, and couldn't imagine what was meant by it.

C Stanley domajot, "Restrictions on the condoms available" is a common sense policy to take the funding we have available for that part of the program and target it toward the highest risk groups. What part of that is so hard to understand? It's not a matter of "denying condoms" to some people, it's a matter of using the resources in the most effective way. There's nothing stopping a private group from coming up with additional funds to drop condoms from airplanes or whatever they want to do to help get more condoms to more people. And as I said, I'd be interested if anyone can find the stats on how many condoms we're distributing now vs. how many were distributed before this program. My hunch is that it's more, but because we've also allocated large amounts of money to the education part of the program people are twisting it by looking at the percentage of total funds going to condoms instead of looking at the absolute numbers. 28% or 30% or whatever of the $15 billion (five year allocation) might actually be higher than the overall amount that the US spent toward these programs prior to Bush's program. But when you focus on the percentages you can point to the 28% or 30% and say, "see, Bush and the Christian organizations really don't believe in condoms!"

C Stanley

HIV infection rates going down looks good, but it’s dangerous to use this as a propoganda tool bedore we understand all the factors at play.

Come on now, domajot. A program is designed to meet a particular goal (in this case, the goal is to create a downward trend in HIV infection rates and deaths). The stats show that the goal is being met, but you're trying to say that pointing out that as evidence of success is propaganda? That's ridiculous. If you want to say that there's success but there could be more, that's an appropriate comment (or, if you have some reason to suspect that there's not cause:effect and the downward trend was due to some other factor); we can always do more and should always be looking for ways to improve. But your comment was far more along the lines of propaganda than is the one that you are aiming that criticism toward.

domajot CS- We're arguing on two separate sites, so this may or may not be addressing the right comment by you. Regarding the interpretation of stats, you are being oversensative. I rail about this in many different contexts. As I have spent years compiling stats, it bothers me a lot when they're used inappropriately, not matter what the topic. Nevertheless, it is true that one cannot jump to a cause-effect inference. The cause-effect relationship may be there, of course, but you can't assume it if you are serious about analyzing a given situation. Re Uganda, I only thought of it after reading the disquiteting news about the rise pf early deaths from AIDS. About private NGOs, the administration has tried to control their behavior when they apply for some portion of governemtn funds, even when those funds are not necessarily directly applied to the frowned on practice. For the rest of my argument, please go to The Moderate Voice, or I will go nuts going back and forth.