|The Secret War on Condoms|
New York Times, January 10, 2003
By Nicholas D. Kristof, New York Times columnist
Over the last few years conservative groups in President Bush's support base have declared war on condoms, in a campaign that is downright weird -- but that, if successful, could lead to millions of deaths from AIDS around the world.
I first noticed this campaign last year, when I began to get e-mails from evangelical Christians insisting that condoms have pores about 10 microns in diameter, while the AIDS virus measures only about 0.1 micron. This is junk science (electron microscopes haven't found these pores), but the disinformation campaign turns out to be a far-reaching effort to discredit condoms, squelch any mention of them in schools and discourage their use abroad.
"The only absolutely guaranteed, permanent contraception is castration," one Catholic site suggests helpfully. Hmmmm. You first.
Then there are the radio spots in Texas: "Condoms will not protect people from many sexually transmitted diseases."
A report by Human Rights Watch quotes a Texas school official as saying: "We don't discuss condom use, except to say that condoms don't work."
I'm all for abstinence education, and there is some evidence that promoting abstinence helps delay and reduce sexual contacts both in the U.S. and abroad. But young people have been busily fornicating ever since sex was invented, in 1963 (as the poet Philip Larkin put it), and disparaging condoms is far more likely to discourage their use than to discourage sex. The upshot will be more gonorrhea and AIDS among young Americans -- and, abroad, many more people dying young.
So far President Bush has not fully signed on to the campaign against condoms, but there are alarming signs that he is clambering on board. Last month at an international conference in Bangkok, U.S. officials demanded the deletion of a reference to "consistent condom use" to fight AIDS and sexual diseases. So what does this administration stand for? Inconsistent condom use?
Then there was the Condom Caper on the Web site of the Centers for
Disease Control. A fact sheet on condoms was removed and, eventually,
replaced by one that emphasized that they may not work.
Evangelical groups do superb work in Africa, running clinics for some of the world's most wretched people - like poor AIDS victims. So it's baffling to see these same groups buying into junk science in ways that will lead to many more AIDS deaths.
(The scientific consensus is simple: Condoms are far from perfect, but they greatly reduce the risk of H.I.V. and of gonorrhea for men, and they probably also reduce the risk of other sexual infections - but more studies are needed to prove the case definitively. See, for example, the National Institutes for Health report at http://www.niaid.nih.gov/dmid/ stds/condomreport.pdf.)
One study by the University of California at Berkeley found condom distribution to be astonishingly cost-effective, costing just $3.50 per year of life saved. In contrast, antiretroviral therapy cost almost $1,050.
Yet the U.S. is now donating only 300 million condoms annually, down from about 800 million at the end of the first President Bush's term. Consider Botswana, which has the highest rate of H.I.V. infection in the world - 39 percent of adults. According to figures in a report on condoms by Population Action International, the average man in Botswana gets less than one condom per year from international donors.
In the time it has taken to read this column, 28 people have died of AIDS, including 5 children. An additional 49 people have become infected. It's imperative that we get over our squeamishness, accept that condoms are flawed but far better than nothing, recognize that condoms no more cause sex than umbrellas cause rain, and ensure that couples in places like Botswana get more than one condom per year.
Originally published in The New York Times, January 10, 2003. Reprinted with permission.