We Do Not Want an HIV Vaccine

My recent post about the “Cheating” poster campaign in Uganda has had some comments here and on facebook. Earlier today I read the comments posted on line at The Monitor in reply to its piece on the same hotly debated issue.

Up front I want to say that I agree, such messaging does need to be tested and the issues it raises are complex and multifaceted.

HIV prevention is a matter about which people quickly form strong views, often influenced by personal faith, world views and perspectives on morality. President Museveni often states how he would prefer Ugandans to either Abstain or Be faithful, and that he is not in support of HIV prevention campaigns that are focused on the promotion of Condoms or male circumcision,(this e.g. in The Monitor from his end of year message).

The argument made is that such promotion leads to increased infidelity and even promiscuity. So if I encourage you to use condoms, that mere encouragement will cause you to have more sexual relationships. It is the same argument that I’ve heard against providing family planning education to teenagers, because that will then lead them to start having sex, which they wouldn’t do if we didn’t mention family planning.

I think that such arguments are somewhat flawed. I agree that society could be healthier if more of us remained faithful to our life-long partner(s). I admire those that do so and would wish for more, but the reality is very different. Can one prove that increased infidelity, or promiscuity, has resulted from HIV prevention and family planning campaigns? If we take such an argument to its logical conclusion then we would not want to see an HIV vaccine developed, and made widely and freely available, because that would certainly cause all those vaccinated to become promiscuous.

So how should we balance the need to prevent the rising tide of HIV infections, more than 560,000 new infections each year, against the possible causation effect of increased infidelity and promiscuity? Public health policies are meant to consider good for society as a whole; I’m not so sure that we should be overlaying these with our individual faith and world views, but rather we should remain objective and evidence-based. I could of course be wrong and I would really be interested in reading any research that you know of that discusses how such campaigns influence behaviour, for good or for bad.

About Kevin Duffy

Interim Management and Consulting - Global Healthcare Development. Kevin has over ten years of senior management experience in the delivery of healthcare services in Africa and South Asia. His current focus is on the strategic development of policy, guidance, and tools to help healthcare organisations achieve sustainable impact – balancing the need to become financially sustainable, with the mission of ensuring equitable access to affordable healthcare services.
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