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ss triple helix - summer 2006,  SAVE versus ABC - The Alphabet Wars of AIDS Prevention

SAVE versus ABC - The Alphabet Wars of AIDS Prevention

In April, Christian Aid declared its support for the new HIV prevention strategy SAVE (Safer practices, Available medications,Voluntary counselling and testing, Empowerment.), as ABC (Abstain from sex until marriage, Be faithful to one sexual partner, and use Condoms) was 'not well suited to the complexities of human life'.[1] Some groups, who support ABC as applied in Uganda, are very unhappy with Christian Aid's announcement; [2] others though feel that ABC is now too pressured by US funding, causing an epidemic rebound due to overemphasis of A and under-emphasis of C.[3,4]

Christian Aid is not against ABC but sees SAVE as a more comprehensive strategy. Developed by ANERELA+ (African NEtwork of REligious Leaders living with or personally affected by HIV and AIDS), SAVE seeks to provide a nuanced and broad based response to the real issues faced by African communities.[5] UNAIDS regards these strategies as integral to HIV prevention, but is not itself promoting any one acronym.[6]

By devising catchy acronyms to encompass complex realities, we can create falsely opposed positions. ABC is highly effective for a general population. It can be embraced by SAVE's Safer Practices arm; but its value is limited for example when working with prostitutes who instead require emphasis on condom use and finding viable alternative employment.[7]

In reality, there are several AIDS epidemics, each requiring a specific strategy. The anger directed by conservative and liberal factions towards the other's methods is obscuring the evidence: we need various locally appropriate and integrated HIV prevention programmes.[8]

God's plan for human sexuality is the ultimate HIV safeguard, yet we are a fallen humanity.[9] Even believers sometimes fail to be sexually pure, let alone those who do not share our faith in Jesus and are without the empowerment of the Holy Spirit to lead regenerated lives. Christians need to address harm minimisation when fighting HIV. Equally, secular groups need to recognise that, without primary sexual behaviour change, condoms are of limited, even detrimental, value.[10] Rather than getting bogged down in childish alphabet wars, the way ahead lies in adopting a more balanced approach, listening to one another and working together with what actually saves lives.

References
  1. www.christian-aid.org.uk/news/media/pressrel/060321p.htm
  2. http://www.ccih.org/Primer on ABC/ABCdoc7.24.06PDF.pdf
  3. www.nytimes.com/2005/08/30/international/ africa/30aids.html?ex=1148097600&en=5c935e9821 649f4d&ei=5070
  4. HIV prevention policy needs an urgent cure. Lancet 2006; 367:1213
  5. www.cpsajoburg.org.za/hivaids/anerela1.html
  6. data.unaids.org/publications/irc-pub06/jc1165-intensif_hiv-newstyle_en.pdf
  7. Green EC. Rethinking AIDS Prevention. Westport, USA: Praeger, 2003
  8. Ibid
  9. Genesis 1:27-28; 1 Corinthians 7
  10. Richens J et al. Condoms and seat belts: the parallels and the lessons. Lancet 2000; 355;400-403
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