Thursday, July 19, 2012

Wesley J. Smith talks sense on AIDS

My friend Wesley J. Smith at Secondhand Smoke has a great post on AIDS prevention:

New HIV Cases Remain Steady–Behavior, Not Healthcare the Key
Thursday, August 4, 2011, 10:47 AM
Wesley J. Smith
I am sorry, but there is no excuse in an advanced and educated country like the USA, which has been grappling at great cost in human suffering and financial output with AIDS for three decades: Last year, 50,000 new cases of HIV were reported. From the NYT story:
Despite years of great progress in treating AIDS, the number of new infections with the virus that causes it has remained stubbornly around 50,000 a year in the United States for a decade, according to new figures released on Wednesday by federal officials. The American epidemic is still concentrated primarily in gay men, and is growing rapidly worse among young black gay men.
AIDS is too often treated as a civil rights rather than a public health issue. And the meme that condoms are the answer, is clearly wrong. Until and unless a vaccine is developed, the only way to end this devastation is for people to indivually restrain their personal conduct. Don’t have sex, except with a mutually monogamous, uninfected partner. Don’t share needles. Don’t pick up someone at a bar and jump into bed. Don’t go to sex clubs (and municipalities should shut them down). Don’t engage in the most risky sexual behaviors involving body parts in which tissues easily tear. Care more about life than sex.
And I, for one, am utterly fed up with AIDS being treated as a political matter:
That realization is causing a rift in the AIDS community. Activists say the persistent H.I.V. infection rate proves that the government prevention policy is a flop. Federal officials are on the defensive even as they concede that the epidemic will grow if prevention does not get better, which they know is unlikely while their budgets are being cut. And some researchers believe it is impossible to wipe out a fatal, incurable disease when it is transmitted through sex and carries so much stigma that people deny having it and avoid being tested for it.
Baloney. Humans have the capacity to restrain their behavior regardless of the urgency of their desires. The time has come to quit worrying about moralizing and create a societal expectation that they do.
And get this rationalizing:
Philip Alcabes, a public health epidemiologist at Hunter College in Manhattan, noted that 50,000 is close to the number of Americans who die in road accidents each year — almost 40,000 — “and in some ways, we consider dying on the road an ordinary thing.” By contrast, he said, nearly one million Americans a year die of heart disease and strokes. “So it’s not clear that prevention is a failure,” he said. “The average adult’s chances of encountering H.I.V. infection — 0.02 percent a year — are rather low. It’s not reasonable to expect that a sexually transmitted virus will disappear in America, or anywhere else. But I agree with Larry Kramer that there has been a dearth of new policy ideas.”
Here’s one: How about a campaign that tells people to just don’t do it unless partnered and monogamous. We don’t hesitate to tell people not to smoke. We even require cigarette packs to carry graphic photos of the health consequences of smoking. It hasn’t ended tobacco use but has materially reduced it. We don’t hesitate to tell people not to drink and drive.
Bottom line: A sexually libertine lifestyle makes you sick (and not just with HIV). No more “you can have your cake and eat it too” anti AIDS advocacy. That’s not prejudice, it is common sense. And, more importantly, it is love.

Smith is exactly right. AIDS is an infectious disease usually spread by a very specific lifestyle: intravenous drug abuse and male homosexual sex. It can be prevented in the majority of cases, just as other diseases with clear predisposing behavioral factors and be largely prevented.  Smith's recommendations are obvious:

Don’t have sex, except with a mutually monogamous, uninfected partner.
Don’t share needles.
Don’t pick up someone at a bar and jump into bed.
Don’t go to sex clubs (and municipalities should shut them down).
Don’t engage in the most risky sexual behaviors involving body parts in which tissues easily tear.

"Care more about life than sex." Human beings are not animals. We are capable of self-control. The trope that condoms are the answer has cost many lives.

We need an honest national discussion about this horrible disease, free of political correctness and politicization. This is a deadly disease for which there is an obvious and very effective prevention.

Chastity-- intelligent moral sexual conduct-- is by far the best way to prevent AIDS.

50 comments:

  1. Sounds like abstinence-only education for adults. I am sure it is destined for smashing success, just like the kids version.

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  2. Abstinence education (i.e. chastity) certainly works better than the birth-control pill worked for preventing out-of-wedlock births and abortions.

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  3. Hmmm, I wonder why the prevalence of AIDS is much higher among the catholic priesthood than in the general population.

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    Replies
    1. Thoughtful readers may wonder why I allow this kind of hateful bigotry.

      I allow it because I hate censorship, and I think there is value in understanding bigotry, which means hearing what bigots have to say.

      If you want to understand bigotry, a good place to start is with troy's anti-Catholic comments.

      Delete
    2. Is it bigotry to point out a fact, an AIDS epidemic among catholic priests, that demonstrates the hypocrisy of the morally bankrupt catholic leaders?

      Delete
    3. Because the priesthood in America was heavily infiltrated by homosexuals in the sixties and seventies. That was a very bad thing, and yeah, it hurts the witness of the Church to truth when members so completely dishonor their vows.

      Delete
    4. That was a very bad thing, and yeah, it hurts the witness of the Church to truth when members so completely dishonor their vows.

      You didn't actually answer the question.

      Delete
  4. Chastity works if the person remains chaste. In the vast majority of cases he or she doesn't. So while chastity never fails, the contraception method based on chastity does.

    In any event, I don't see why gays can't rely on both monogamy and condoms. Explain that to me.

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    Replies
    1. Because homosexuality is male sexuality totally UNRESTRAINED by the female demand for exclusivity and fidelity. Male sexuality has a very strong tendency for variety. So that this positive feedback loop provokes extremely high levels of promiscuity.

      Delete
    2. And this interferes with the use of condoms exactly how?

      Delete
    3. Oleg,

      "In any event, I don't see why gays can't rely on both monogamy and condoms."
      If they are monogamous the condom is a redundancy. Due to the nature of the sexual relations gays engage in, I would think condom use is a good idea - even when monogamous.
      But monogamy is the key, Oleg.

      Delete
    4. But you agree, crus, that one can advocate both, can't one?

      Delete
    5. It doesn't interfere with the use of condoms, Oleg. It just makes them unreliable. Even a small degree of systemic failure is important if there is frequent activity. You will most likely avoid pulling the Queen of Spades out of a deck of cards for a while. Only one card out of 52, right? But every time you shuffle and deal yourself a new card brings you closer to the inevitable event. You will pick the Q of S, sooner or later.

      Delete
    6. David,

      condoms fail rarely. That means that they substantially reduce the risk of getting an STD. If you think that reduced risk isn't worth the hassle, you are totally wrong.

      Delete
    7. Another possible explanation of your comment is that you have an ideological axe to grind and intentionally obfuscate the issue. But you wouldn't do that, right?

      Delete
    8. With AIDS, Oleg, I wouldn't want to REDUCE the risk. I would want to ELIMINATE the risk. Condoms won't do that.

      Delete
    9. Ideological axe? I don't think so. I just don't have a high opinion of condoms. Years ago I mixed it up with a group of looney Bible thumping fundamentalist (the sort who think Billy Graham is a heretic) over this very issue. They thought the Pope's dismissal of condoms in Africa condemned people to AIDS. The facts are different. Whatever encourages and facilitates promiscuity makes acquiring AIDS more likely.

      Delete
    10. @David:

      I agree. There is a story about a speaker at an international aids conference who asked his audience of aids experts if anyone would have intercourse with the person of their dreams if they were protected only by a condom. No one in the audience said they would.

      So the speaker asked: "So why do we suggest that other people protect themselves with condoms?"

      Delete
    11. And like most stories promoted by the loony Right, there is no evidence this incident actually happened. No one else, except far-right religious crackpots, remembers it.

      Delete
    12. It's especially appalling when a medical doctor—who should know better—spreads false stories like that. It's preposterous.

      Delete
    13. @oleg:

      Oh, the outrage..

      How about the point of the story? Should we be telling people to protect themselves using a method we would be unwilling to use ourselves?

      Would you have sex with a casual partner who had AIDS, only protected by a condom?

      Delete
    14. Caught red-handed repeating a lie, Egnor shamelessly tries to divert attention from his own dishonesty...

      Delete
    15. The story is made up, so why would I even care?

      My point is simple. If you can manage to not have casual sex, great. However, if you do then be sure to use a condom. It will not eliminate the risk of getting an STD entirely but it will reduce it very substantially.

      Here is what the FDA says on the subject:

      Will a condom guarantee I won't get a sexually transmitted disease?

      No. There's no absolute guarantee even when you use a condom. But most experts believe that the risk of getting HIV/AIDS and other sexually transmitted diseases can be greatly reduced if a condom is used properly.

      In other words, sex with condoms isn't totally "safe sex," but it is "less risky" sex.

      [end of quote]

      So what would I do? It's a simple answer, and I am not sure why you are pestering me with your question. I'd rather not have sex with a stranger. But if I did then I would use a condom.

      Delete
    16. oleg:

      Your daughter asks you: "Dad, I met a guy with AIDS, we'd like to have sex, is it safe if he just wears a condom?"

      Why would you give your kid advice that is different from advice you give other people's kids?

      Delete
    17. The CDC has lots more details on this. Here is a brief excerpt:

      Laboratory studies have demonstrated that latex condoms provide an essentially impermeable barrier to particles the size of HIV.

      Theoretical basis for protection. Latex condoms cover the penis and provide an effective barrier to exposure to secretions such as urethral and vaginal secretions, blocking the pathway of sexual transmission of HIV infection.

      Epidemiologic studies that are conducted in real-life settings, where one partner is infected with HIV and the other partner is not, demonstrate that the consistent use of latex condoms provides a high degree of protection.

      [end of quote]

      Unlike your apocryphal story, this summary is backed up with references to peer-reviewed papers, with actual names behind them.

      Delete
    18. Egnor, you keep dealing with hypothetical, and extreme, situations. How about you look at it from a real-life position? From a public-health point of view? Is that a novel concept for you?

      Delete
    19. Answer my question. Your daughter is waiting patiently. She wants your advice.

      Delete
    20. Here is the advice I would give the hypothetical daughter.

      Your questions are pretty naive for a doctor, Mike. What advice would you give your teenage daughter when she tells you that she is going out with friends in a car? Driving is risky, teen driving much more so.

      Delete
    21. The first sentence of the reply at your link:

      "My brother went to Tijuana last weekend and had sex with a stripper..."

      Quite the fatherly reply to your daughter.

      Here's my reply:

      "Sweetheart, your life is much too precious to endanger that way. And you are too precious to be giving away you body in such a way. Please save your love for the man who will love and honor you for life."

      I guess we're just different kinds of fathers.

      Delete
    22. The virus doesn't care whether you are a stripper or a saint. In any event, the daughter should be getting the most information available. I have provided answers backed up by the CDC and medical experts. You have told her a fairy tale.

      Delete
  5. "We need an honest national discussion about this horrible disease, free of political correctness and politicization. This is a deadly disease for which there is an obvious and very effective prevention."

    Not to mention free of so-called religious leaders as well.

    Simply looking down your nose and telling people to not have sex, but don't use condoms either if you do, isnt going to do much. HIV isnt just in the gay community, either.

    Again, I think interest in this issue by some is motivated not by caring for one's fellow man, but by religious teachings- that homosexuality is an abomination

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    Replies
    1. @Mulder:

      [Again, I think interest in this issue by some is motivated not by caring for one's fellow man, but by religious teachings- that homosexuality is an abomination]

      We all have motives, Mulder. Do you think that opposition to chastity education and support for condoms might possible remotely maybe be motivated by... lust?

      Delete
    2. As well as the societal endorsement of artificial contraception, by which men encourage the reduction of women to sex toys.

      Delete
  6. mregnor "Abstinence education (i.e. chastity) certainly works better than the birth-control pill worked for preventing out-of-wedlock births and abortions."
    Meanwhile, here on ActualEarth (vice TheoreticalEarth), people have sex (as they have in the past, and will continue to do so). As such, ActualSex-Education (and ActualContraception) are superior to TheoreticalActions.

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    Replies
    1. @Modus:

      [Meanwhile, here on ActualEarth (vice TheoreticalEarth), people have sex (as they have in the past, and will continue to do so).]


      Chastity is not opposition to sex (celibacy is abstinence from sex).

      Chastity is sex with committed (married) monagamous love between a man and a woman.

      Believe it or not, Modus, that can be the best sex.

      July 19, 2012 11:17 AM

      Delete
    2. “Chastity is sex with committed (married) monagamous love between a man and a woman…can be the best sex.”

      Maybe for religious fanatics burdened by shame, guilt, and fear, because they think their invisible friend is watching and they don’t want to be tortured forever.

      Personally I’m quite happy with my hard-bodied 24 year old sugar-baby…for now. You should try being an animal every once in a while, it’s fun.

      -KW

      Delete
    3. Dr Egnor is correct, KW.

      Having been both the animal in the past and the gentleman more recently, I can happily confirm that being the gentleman is best.
      Best for your heart, soul, and body.
      The sex is way better too. No two ways about it!
      It's the difference between gulping down a cheeseburger with fries and a coke at a fast food joint with a work buddy, and savouring a chateaubriand with crisp greens, garlic roast, and a nice vintage with someone you deeply love .
      Your 'hard bodied sugar-baby' (I presume that means you are her 'sugar daddy'?) may be a good person, but she will get sick of being a paid scratching post for an 'animal' and eventually want a man to treat her like a lady. Maybe when she grows up and leaves school?
      You may want to consider applying your favourite theory and evolving!

      Delete
    4. crus: Having been both the animal in the past and the gentleman more recently, I can happily confirm that being the gentleman is best.

      That may be so, but nearly everyone comes to this conclusion having first gone through an animal phase. Ergo we should not rely on the abstinence-only approach.

      Delete
    5. This comment has been removed by the author.

      Delete
    6. The only "point" you made (as best I can see) is that sex in the real world is too wild to be constrained by chastity. It is to that I responded.

      I'm not sure what the Guttmacher Institute has to do with your "point".

      Delete
    7. Sorry, mregnor. I was deleting that at about the same time as you were replying.

      Delete
    8. Oleg:

      [That may be so, but nearly everyone comes to this conclusion having first gone through an animal phase. Ergo we should not rely on the abstinence-only approach.]

      That's mostly a modern phenomenon. There were times in which chastity was the societal norm, if often violated.

      The Sexual Revolution changed all that. An epidemic of disease, broken marriages, out-of-wedlock births, abortions and sex crimes followed.

      Progress.

      Delete
    9. mregnor "I'm not sure what the Guttmacher Institute has to do with your 'point'."
      The dismal results of ab-only sex-ed, I'd hoped. Actually, I remember a second link (which must've got cut out during my editing process) specifically linking to such state-wide tales of woe as Texas and Mississippi.
      Comprehensive sex-ed (with an abstinence component) works better than ab-only, which doesn't work at all. The best that I can come up with for ab-only is that teens, on average, start having sex 12-18 months later. That "best" is swamped by them being more likely to tend toward more unsafe, um, variants on the act, and are less likely to use prophylactics/contraception when they do.

      Delete
    10. @Modus:

      The GI is the propaganda arm of Planned Parenthood. Obtaining your information on abstinence education from Guttmacher is like obtaining your information on smoking from Philip Morris.

      Effective abstinence education would put the GI and it's congener Planned Parenthood out of business.

      The failure of abstinence education is the beginning and end of the GI-PP business model. These butchers will do whatever is necessary to discredit it.

      Delete
    11. mregnor "The GI is the propaganda arm of Planned Parenthood. Obtaining your information on abstinence education from Guttmacher is like obtaining your information on smoking from Philip Morris."
      Dismissing something because you disapprove of the source is a logical fallacy. Dismissing statistics because you don't like the statistician is idiotic. I mean, I think Beck is a dangerous loon, but if he said "The sky is blue" I'd at least go outside and look up before poo-pooing his statement.

      "Effective abstinence education would put the GI and it's congener Planned Parenthood out of business."
      It's that first word that's the problem. If you drew a Venn Diagram of "states that teach ab-only" and "states with high teen pregnancy rates" the overlap would be considerable.

      "The failure of abstinence education is the beginning and end of the GI-PP business model. These butchers will do whatever is necessary to discredit it."
      That is not an argument. PP could be a bunch of Hitlers barebacking Stalins, and it would have no effect, zero, none on the failure of ab-only sex-ed.

      Delete
    12. Oleg,

      "That may be so, but nearly everyone comes to this conclusion having first gone through an animal phase. Ergo we should not rely on the abstinence-only approach."

      I truly wish I had no comparison to make.
      I gained nothing from the 'animal phase' except misery, drama, and wasted time. It's not something I brag about, although some would... It is, rather, something I am quite ashamed of , now that I am an adult with a family.
      I can safely say I regret such behaviour and wish I had gone straight for the real stuff, and left the hollow, commercial, conformist view of sex to the sheeple.

      Delete
  7. Yeah KW. You demonstrate your total devotion to each other by withholding an important part of yourself from your 'beloved'. The best sex I ever had, by far, was when we gave up the pills and opened our lives to the possibility of new life.

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  8. @KW:

    [Maybe for religious fanatics burdened by shame, guilt, and fear, because they think their invisible friend is watching and they don’t want to be tortured forever.

    Personally I’m quite happy with my hard-bodied 24 year old sugar-baby…for now. You should try being an animal every once in a while, it’s fun.]

    It's nice to know that nothing as base as religious motives have colored your views on sexual ethics.

    ReplyDelete
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    ReplyDelete