by Nigel Marsh - Hope Communications

BARCELONA, July 9, 2002 - World Vision's preferred policy of promoting abstinence and faithfulness as the primary means of controlling the HIV pandemic, while retaining the option to encourage condom distribution as a valid but less-preferred third part of the strategy, is well received in most quarters at the Barcelona AIDS2002 conference.

An Associated Press journalist yesterday described it as 'the most sensible explanation of a prevention strategy' that she had heard so far. Most other faith-based representatives who have commented acknowledge the roundedness and wisdom behind the concept. And non-faith experts are increasingly, if grudgingly, coming to accept at least the equality of value of the various components in a good prevention campaign.

One of the interesting trends at this year's International AIDS Conference is the lack of public controversy over the role that is and should played by the promotion of condoms as a means of preventing HIV transmission.

This is in part due to the apparent assumption by supporters of barrier methods of prevention of transmission that they have won their argument, and partly due to a growing acceptance that faith based organizations have a valid role in the fight against AIDS on their own terms and should not be pushed to adopt positions alien to them.

On a deeper level, though, there is a recognition in informed quarters that behavioral change is, indeed, a more successful strategy than promotion of male and female condoms. In the terminology of AIDS specialists prevention is divided into three broad areas - abstain (A), be faithful (B), and use condoms (C). And World Vision has neatly encapsulated its approach in the formula 'A, B and small c'.

"We've been suggesting for some time that this is the right approach from World Vision, and something that the majority of our government and private supporters can understand and come behind," says Hope team leader Ken Casey, the special representative of the World Vision International President on HIV and AIDS.

"We want to major on the need to get young people to delay their sexual debut, and for people who have sex, to stick to one partner, preferably within marriage," he said. "But we do recognize that in many cases, and certainly in high-transmission areas, it may be necessary to promote the correct and consistent use of condoms as an urgent way of saving lives.

"We do not say that condom use is morally equivalent to abstinence at all. But the sanctity of life is a Christian belief that can be served at one level by physically reducing the harm that unrestrained sexual activity can cause while we seek, simultaneously, to bring behavior change in very difficult circumstances."

While the reason for adopting the approach is based in World Vision's values and faith-based ethos, influential recent papers by non-Christian researchers back up the efficacy of the AB-c approach. Notable among these is the work done by Edward Green that says promotion of abstinence and faithfulness by religious organizations has been highly successful in reducing transmission in Uganda and Haiti.

"It is fascinating to me that our approach is being validated by an independent, professional, scholarly researcher," said Casey. "One of the leading thinkers on the subject of human behavior, Harvard anthropologist Ted Green, identifies the fact that the two behavioral changes most closely correlated to reduction in prevalence rates are delaying the age of sexual debut and reducing the number of sexual partners.

"This encourages us that World Vision is ahead of the field in adopting these techniques and arguing for the kind of thinking that really will save lives in future.

"There is a role for the promotion of condoms, particularly with high-risk groups, but we must be careful to present this in the context of the whole picture of what we believe and what we are working towards. And we must also not be ashamed of the fact that we came to this programmatic position because of our faith-based thinking.

"We're not doing it because Green says it's OK, but we welcome the fact that his fair-minded research reassures us that we have adopted a scientifically meaningful approach."