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Saturday, August 20, 2005 

Swaziland admits: abstinence doesn't work.

Thinking that you live in a culture-free decadent shithole full of selfish attention whores can get you pretty depressed. Knowing that the religious right wants the exact opposite of this always makes me feel just a bit better. Articles like this are then the equivalent of the best sex you've ever had combined with a feeling of euphoria you get from knowing that those you hate are wrong:

The King of Swaziland has abandoned a four-year campaign to enforce chastity among teenagers following criticism of his own behaviour and with figures showing that the policy has completely failed to stop the spread of HIV in the country.

The announcement in the kingdom's papers yesterday coincided with the release of government statistics revealing nearly a third of Swazi 15- to 19-year-olds carry the virus that causes Aids, the scourge King Mswati III had hoped to combat with his appeals to girls to remain virgins.

Alarmed at the high rate of HIV infection, Mswati in 2001 reinstated for five years the "unchwasho" rite, banning sexual relations for unmarried girls younger than 18.

Swazi girls were instructed to wear a tasselled scarf as a symbolic badge of virginity.

If an unchwasho girl was approached by a man, she was expected to throw her tassels at his homestead, forcing his family to pay a penalty of a cow.

When the king chose a 17-year-old as his ninth wife in 2001, about 300 young women marched to a royal residence, laying down their tassels in protest.

The king's aides argued the ban was designed to discourage casual relationships, not marriage. But Mswati surrendered the cow, which was roasted and eaten by the young women.

As a result of criticism that he has behaved hypocritically, the king decided to end the teenage chastity rite a year early.

The Aids crisis has compounded poverty, with estimates that 480,000 people now carry HIV. Aids has hit Swaziland harder than almost any country in the world.

According to results released yesterday, 29% of 15- to 19-year-olds are HIV-positive.

The report said 42.6% of pregnant women tested at clinics were infected and 40% of adults aged between 30 and 39 who opted for voluntary counselling and testing were HIV positive in 2004.

One of the tenets of the Bush administration's foreign policy, especially on Africa, is that countries will not receive any aid towards family planning clinics or anything that even suggests the evil that is abortion. This also applies to a lesser degree on condoms. The religious right is convinced of the virtue of this policy; after all, sex before marriage or with multiple partners is going to send you straight to hell. This obviously ignores the HIV/Aids pandemic which is sweeping through Africa, leaving a whole generation of children growing up as orphans, many themselves born with HIV. It's therefore heartening to hear that the king of Swaziland himself has admitted that such a policy is a complete disaster.

The UN supported fight against Aids in Africa is often referred to as ABC: abstinence, be faithful, condoms. The US problem is that it only wants the A and the B of that plan. Not only does this ignore the cultural differences of Africa, it also misunderstands the difficulty of a lot of women in the continent in saying no to male advances. It's often the husband who passes on the virus to his wife after he's slept around with other women without using condoms.

Uganda is widely regarded as the best model in the fight against AIDS; a report found that while prevalence of HIV was 15% in 1992, this has now dropped to around 6%, although this has been disputed. This was mainly due to education on abstinence and condoms in schools, as well as prophylactics being made widely available. The very worst advice comes from the Catholic church, which claims that condoms have microscopic holes which let HIV through.

It's about time that the United States stopped deluding itself over some of its very worst and inhumane policies. Sucking up to the religious right might work in the short term, but as usual it's storing up even more problems for the future. If we let the religious right impose their false moral superiority over Africa, it'll be us next.

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Probably pointless to respond so late, but ... a) thanks for the news on Swaziland and the spot on commentary about U.S. atrocious (literally) policy.

b) "Prevalence" = level of disease in population, as distinct from "incidence" = quantity or rate of new disease. The declining HIV/AIDS *prevalence* in Uganda reflects the practices cited, which reduce incidence (new disease), **plus deaths**.

Declining incidence is good news. Rapid declines in prevalence reflect declining incidence, plus failure to get life-prolonging therapies to poor people in Africa and elsewhere.

Best news would be declining incidence plus declining death rate, which probably wouldn't change prevalence that much.

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