When Condoms Fail: An Alternative Approach To HIV Prevention

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by Anna Cosio.

Although the Philippines currently has one of the lowest HIV prevalence rates in the world at 0.10% and ranks 108th according to CIA 2016 data, there has been a reported surge in the number of cases recently.[1] But instead of resorting to knee-jerk reactions, let us consider what could have possibly caused this recent increase and solve the problem at its root. Band-aid solutions will only make it worse.

In 1984, the first case of HIV/AIDS was reported in Thailand and in the Philippines. Thailand promoted condoms and liberal sex education, while the Philippines, a predominantly Catholic country, promoted abstinence and faithfulness to one’s spouse. Look at where the two countries are now. As of 2016, Thailand had 450,000 people living with HIV/AIDS, while the Philippines had 56,000. In terms of prevalence rates, Thailand ranks 40th in the world, while the Philippines is 108th. In 2016 alone, 14,200 people died of AIDS in Thailand, while less than 1,000 died of AIDS in the Philippines.[2][3] There may have been a drastic increase in HIV cases in the Philippines in the past few years, but it would be wrong to attribute this increase to an alleged lack of liberal sex education or condom promotion, obviously because even without them, we had been able to keep the numbers low until only recently. We had been doing something right until the last few years. So what happened? What changed? Why are the numbers rising all of a sudden? These are just some of the questions that we need to ask. Find out the root cause of the problem, instead of making baseless assumptions or blaming the Church again.

Harvard AIDS expert Dr. Edward Green said that what really works in preventing the spread of HIV is behavior change, particularly a reduction in the number of sexual partners and staying faithful. He also explained that condom promotion has failed to solve the HIV problem in Africa due to a phenomenon called “risk compensation”, wherein a person who thinks s/he’s fully protected by a condom tends to engage more frequently in risky behavior, thereby increasing his/her chances of getting infected despite using condoms. There’s a study showing that condom effectiveness for HIV prevention among men who have sex with men (MSM) is only 70% with reported consistent use and “and no significant protection when comparing sometimes use to never use”.[4] As a friend of mine said, “You have better odds with Russian roulette! Russian roulette survival rate is 83%!” Then there is also the World Health Organization (WHO) study showing that the success rate of condoms in preventing HIV incidence in heterosexual sex is only 80%.[5] But advocates promote condoms as though they offer 100% protection. This is a dangerous message, because the failure rates are pretty high and yet they are marketed as though they were foolproof. They are giving people a false sense of security. There are even people who claim to be anti-HIV advocates, but are encouraging casual sex with multiple partners among men, saying they’ll be fine as long as they use condoms and have themselves tested. HIV testing is a good measure, but it is neither a cure nor protection. This is really disturbing, considering 83% of HIV cases in the Philippines from January 1984 to April 2017 were males who have sex with males (MSM).[6] (I won’t mention the name of their org publicly, but you can ask me via personal message and I’ll send you the link to their website.)

Behavior change is surely the more difficult action plan, but it’s what really works and should be what we are all massively campaigning for. This is not even a “religious” measure. Old fashioned, maybe. But old-fashioned does not necessarily mean outdated. If you want to be truly safe and if you want to live longer, forget casual sex and be faithful.

[1] https://www.cia.gov/library/publications/the-world-factbook/rankorder/2155rank.html

[2] https://www.cia.gov/library/publications/the-world-factbook/geos/th.html


[4] https://www.ncbi.nlm.nih.gov/pubmed/25469526

[5] https://extranet.who.int/rhl/topics/hiv-aids/hiv-prevention/condom-effectiveness-reducing-heterosexual-hiv-transmission

[6] HIV/AIDS and ART Registry of the Philippines (HARP) April 2017

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