The Finch Formerly Known As Gold

30 January 2005

Stretching the truth

The right side of blogdom has had a lot of fun with the most recent Consumer Reports condom test, which ranked a condom distributed by Planned Parenthood as the least effective.

Obviously their latex products, which are given away for free, are worth the price, but how about their advice?

Every reputable sexuality education organization in the U.S., as well as prominent health organizations including the American Medical Association, have denounced abstinence-only sexuality education. And a 1997 consensus statement from the National Institutes of Health concluded that legislation discouraging condom use on the grounds that condoms are ineffective "places policy in direct conflict with science because it ignores overwhelming evidence ... Abstinence-only programs cannot be justified in the face of effective programs and given the fact that we face an international emergency in the AIDS epidemic" (NIH, 1997).

I'd like them to try to explain this:

The African nation of Uganda, until recently suffering one of the worst cases of post-colonial political corruption and social misery, has surpassed all expectations in its AIDS program based on abstinence and social cohesion. Uganda has decreased its rate of AIDS by as much as 75% in some demographics, an unprecedented success in the story of African AIDS combat.

You want more statistics? Here you go.

This actually explains much about those crummy condoms Planned Parenthood distributes: after all, their logic is also full of holes.

(Addendum, 31 January, 5:50 pm: As apparently is mine, in spots. See comments. Also, see Bruce's take on this issue.)

Posted at 11:04 AM to Life and/or Death

Well, you've hit me where my information button is located.

Unfortunately the Uganda model has been debunked a few months ago starting with the on the ground research of an NGO operating inside of Uganda (National Guidance and Empowerment Network of people living with HIV/Aids in Uganda (NGEN))AND corroborated by more objective health monitoring organizations ... rates are estimated to be 3 times higher than the government reports ... folks with certain agendas were quick to jump on the "success story" and much like an online legend was promptly reported on sites around the world (some pro-life old liners and other semi-legitimate MEDICAL sites) and it has finally made its way into blogdom ... but how would the average (or above average)blogger know? I suggest they can't and nay should they be expected to fully vette these claims ... but I would be remiss in my duty if I didn't bring this contrarian perspective to light in view of the deadly consequences. The Ugandan government like many in that region are devastated by AIDS and its fallout, both social and economic, and are seeking the best picture on the face of its problem so as to attract the best resources and most money to its cause but like all such endeavors the road to snopes is paved with misinformation (intentional or well intentioned as the case may be).

... as for the condom failures ... well ... having personally visited the Consumers Reports site it cites Planned Parenthood samples tested as specifically MEETING the standards. Now was there a group of condoms that failed ... yes ... 2 specifically and under "rigorous" testing ... are they distributed exclusively by ALL planned parenthood facilities ... NO. So a condom distributed by A Planned Parenthood facility (unnamed of course) was one of the failure models? The article conveniently left out the brand that failed so we the reader could vette that information against the report from Consumers Reports (it was the Durex Pure Protection Spermicidally Lubricated and Trojan Plus 2 Spermicidal) but also in the actual Consumer Reports report is the fact that ONE SPECIFIC LOT NUMBER of one of the BEST rated condoms failed (the blow up test ... which is a VERY RIGOROUS TEST and I dare say NOT replicable in the wild:) as well ...

And one last thing ... In the article cited (Reuters UK --Washington DC tagline) the statement was also made: "The New York-based organization, which publishes the Consumer Reports magazine, also tested 16 other contraceptive choices." "Condoms remain the only family planning and pregnancy prevention method that can help prevent sexually transmitted diseases, including HIV, which causes AIDS," the group, which has issued similar reports on condoms periodically since 1979, said in a statement."

My final take: Not doing something (abstinence) does INDEED remain the BEST theoretical alternative and practice (Remember good ole Nancy Reagan saying "Just Say NO"?) but condoms provide the most realistic approach to ongoing sexual risk behavior just like treatment does for ongoing drug behavior .

Now I settle back for the flames to consume me ... come for me my darling flickers of oxygenated reaction ... take me home :)

As always ... your servant

Posted by: Ron at 12:16 PM on 30 January 2005

I assume you can cough up a link for this debunkage? I spent about 15 minutes looking for contrary material, to no avail.

Posted by: CGHill at 12:41 PM on 30 January 2005

I note that the Ivory Coast is also considering a similar program. The link is in Spanish, but its an interview with Christine Nebout-Adjobi, who is the Minster for that country's fight against AIDs.

Robert Duncan

Posted by: Robert Duncan at 1:55 PM on 30 January 2005

I am an idiot: here's the link

Lucha contra el Sida

Posted by: Robert Duncan at 1:57 PM on 30 January 2005

You're conflating two different things. Planned Parenthood is dissing abstinence-only programs, not abstinence-first programs. They haven't ever said that abstinence as a means of preventing STDs (and pregnancy, for that matter) shouldn't be taught. Furthermore, the Ugandan program is not an abstinence-only program. It's ABC (A = Abstinence, B = Being faithful to one partner, C = Condom use). I really doubt Planned Parenthood would consider that to be a wrong-headed approach or ineffective.

Posted by: Lesley at 2:44 PM on 30 January 2005

Given some of the stuff PP has put out on their Teenwire site The Dawn Patrol has covered this extensively I am not persuaded that they're capable of endorsing anything that might cut into their primary revenue stream, which is disposing of unwanted pregnancies; we are apparently supposed to be rutting like barnyard animals, and the sooner we start, the better.

Posted by: CGHill at 2:52 PM on 30 January 2005

Sigh, you're going to make me go to their website and see if they've said anything favorable about abstinence, aren't you? Oh fine. I'll be back later. :)

Posted by: Lesley at 3:36 PM on 30 January 2005

OK I'm back.

1. Is Abstinence Right For You Now?.

2. Teensex? It's Okay To Say: No Way!. In which, BTW, they freely acknowledge that about 50% of teenagers have not had sex.

3. It Can't Happen To Me!. Specifically - "HIV Risk Comparisons. NO RISK ? Continuous abstinence from sex play and needle use. Masturbation."

4. Reducing Teenage Pregnancy. Specifically (emphasis mine) - "'Balanced and realistic' sexuality education programs that encourage students to postpone sex until they are older, but also promote safer sex practices for those who choose to become sexually active, have been proven effective at delaying first intercourse and increasing use of contraception among sexually active youth."

So I stand by my original comment. Planned Parenthood has not said abstinence as a means of preventing STDs and pregnancy should not be taught.

Posted by: Lesley at 4:11 PM on 30 January 2005

You're seeing the phrase "balanced and realistic" as though it were being spoken by normal persons such as yourself. PP undercuts it right there in #4: postponement for some, promotion of "safer sex practices" for those who don't "postpone." I should be so abstinent. (Oh, wait....)

And I do mean promotion. Ask their Teenwire site about some old-fangled concept like, oh, virginity.

Posted by: CGHill at 5:49 PM on 30 January 2005

Well, unless the teens become nuns or priests, I do think the abstinence while a teenager is just a postponement. I mean, it's reasonable to think that the vast majority of them are going to have sex eventually. Even if we all wait until we get married, most people are going to have sex at some point in their lives.

We're obviously just coming at this with very different mind sets. I read the link you provided, and I think they're telling the teenager it's okay not to have sex. Now, are they also saying that they might choose to have sex? Yes. It isn't all that very different from what my mother told me when I was 16. Which was basically that she really thought I was too young to have sex, because there were emotional ramifications to it, but if I was going to have sex, to come talk to her. She wanted to make sure that I had birth control. Because as much as she really did not want me to have sex until I was older, more important was that I did not get pregnant too young. Well, she got her first wish. I didn't have sex for several more years. Not that I went and talked to her when I did, but I was old enough to be responsible about birth control. But I don't think she was wrong to handle it the way she did. She was very clear about not wanting me to have sex. However, she also didn't want me to have an abortion or become a single mother.

Posted by: Lesley at 8:12 PM on 30 January 2005

I think it's fairly inevitable that a rather large percentage of teenagers are going to have some sort of sex, parental opposition notwithstanding. What frosts me about PP is their apparent unwillingness to keep parents in the information loop: they and their friends in state legislatures get bent horribly out of shape over things like parental-notification bills. We probably do have different mindsets at one level, but I don't think we're too far apart on the parenting aspects.

Posted by: CGHill at 8:23 PM on 30 January 2005

All the information I've read (10 tabs at the moment) all suggest that the success of Uganda's effort to reduce HIV/Aids is a multi-pronged approach. Which means its not an abstinence-only or a condom-only one, but one that combines both with education as well.

The two quotes that you offer as contrast DO NOT contradict each other. Reading the first, you see that it condemns abstinence-only programs but not ones that promote abstinence as well as other means of risk reduction.

Personally I think the sucess in Uganda is in education, identifying the people with AIDS and telling people how to prevent teh further spread. People then made the common sense decision to reduce their own risk.

Is the program in Uganda an abstinence only one?

The website of the Uganda AIDS commission seems to suggest otherwise, with information about condom use as well as a heavy emphasis on education about the real risks of HIV. Its called the ABC approach, Abstinence, being faithful and condom use.

Here's a great paragraph from one of their documents:

"Part of the whole problem is precisely the "ever increasing polarization between left and right". Some in the religious right have in fact attacked broader contraception and progressive social programs in the same breath as they have attacked the condom distribution (or "condom airlift") solution to AIDS. This has put liberals so much on the defensive that they will simply not listen to logical public health arguments on the need to address risky sexual behavior in the pandemic driven by risky sexual behavior. Partisans on the left and the right are currently fighting over how the newly promised billions for AIDS prevention to be spent. The fight seems to have once again been reduced to condoms versus "abstinence" forgetting that the lesson from Uganda is that balanced, integrated appraoch that provides a range of behavioral options is what works best."

I feel that is a pretty fair assesment. So how can it be that partisanship has trumped good policy? I dunno, but this liberal will admit that a good policy towards preventing AIDS has to incorporate behavioral changes as well as other methods of risk reduction.

BTW, Thanks for heads up, I learned a ton about AIDS today! You should do some more research as well.

Posted by: bruce at 9:20 PM on 30 January 2005

If teenagers get condoms from their school through a planned parenthood sponsorship and then contract an std, should they sue the school or planned parenthood?

Posted by: Randy at 9:21 PM on 30 January 2005

oh, and by the way, your post is misleading and you should correct it.

Posted by: bruce at 9:29 PM on 30 January 2005

I don't think it's particularly misleading, though I don't think it's especially well-written either. (There are a few cringeworthy items scattered here and there in the archives; at least they seem so now.)

And I figure if we both learned something, it was worth it.

Posted by: CGHill at 11:40 AM on 31 January 2005

You're presenting the quote about Uganda as a contradiction to the quote about planned parenthood, when its clearly not the case, what part of that IS NOT misleading?

In fact several of the comments here did in fact "explain this" to what I felt was a sufficient level of "smackdown". Ron, Lesley and myself all made valid points that refuted your assertion: That the case in Uganda contradicts the statements made by Planned Parenthood that abstinece-ONLY programs are not justified in the face of effective programs.

In this case the effective program in Uganda DID include the use of condoms AS WELL AS abstinence.

Or am I reading too much into what was intended as a factually challenged cheap shot at Planned Parenthood? In which case:

"Haha good one Chaz! What dolts, don't they know any better?"

Posted by: bruce at 12:57 PM on 31 January 2005

CG, I don't want to make it seem like I'm picking on you. But I feel its important to stop the spread of the "Uganda proves abstinence-only works" message that is making the rounds. Your post may have been a bit more roundabout in making that claim; the website that you link to : ( actually goes so far to make the assertion that people should use Uganda to win a debate about abstinence-only effectiveness. The facts don't support that claim.

I was only hoping that you would fess up and let your readers know that Uganda is not the poster child for Abstinence-only AIDS prevention.

Posted by: bruce at 1:06 PM on 31 January 2005

Well, I'm not above a cheap shot at Planned Parenthood, as I've proven once or twice.

But I didn't intend to imply that Uganda deserved poster-child status, only that it flew in the face of some of PP's more bizarre utterances. To that extent, I botched the assembly of the piece. It wouldn't be the first time I got from A to C without the best possible B.

Posted by: CGHill at 1:24 PM on 31 January 2005

thank you

Posted by: bruce at 5:39 PM on 31 January 2005

Now really - when people think of PP, do they think of abstinence messages or condoms? That they would acknowledge, effectively in fine print, a truth apparent to the most feebleminded among us - that no sex means no kids and no STDs - IMO is nothing more than CYA. It's not their primary message and we all know it. Suggesting that

Thought experiment: Change PP's name to Enron. Point out that they distribute a product whose failure rate is high even with best usage regardless of brand, and that dealing with such failures contributes 34% of their income. Does that make things look any different?

If PP or anyone else wants to fight AIDS, hepatitis, Ebola and any number of other diseases in Africa, they should be shipping hypodermic needles, not condoms. Condoms are inherently failure-prone, short-lived and often ignored, and without needles even abstinence can't protect against 100% of the risk of STDs.

Posted by: J Bowen at 2:02 PM on 4 February 2005