Wednesday, June 23, 2010

It's the behaviour, stupid!

Not the nicest of titles, is it? But when in the world are we going to learn two home truths:

Making a baby is the natural result of having sex. There are only two sure-fire methods of birth control: abstinence and hysterectomy. Not even vasectomy or tubal ligation are sure things - just ask the couple who were featured on 60 minutes some years ago who had undergone both procedures and still had a baby.

Now, for the last time. Babies are the natural result of having sex. That is what is supposed to happen. Trying to deny it by various methods is a fool's errand that will, almost inevitably, fail. If you doubt me, take a look at the countries in Africa which have the most vigorous condom promotion programs -- they also have the highest rates of HIV infection. Those same failures which enable virus transmission enable transmission of other things as well - like those little critters that come a' knocking on your nice egg's door (speaking to my female readers). Which brings us to:

The second home truth is that we can wipe out an entire class of diseases in one generation by making one simple (yet not easy) change in our behaviour. Abstinence before marriage followed by faithfulness within a lifelong marriage will rid the world of HPV, Chlamydia, Syphilis, Gonorrhea, Herpes (HSV2, the primarily sexually transmitted type of HSV), and yes, you guessed it, HIV/AIDS.

Condom promotion has not helped Africa one little bit. In fact, it may have done a great deal more harm than good as Matthew Hanley points out today in On the Square:

But risk reduction measures have a deeper and more damaging defect: a deflating absence of hope. They too often imply that we cannot influence behavior—that the best we can hope for is reducing and controlling the damage of behavior people will engage in whatever we say. More damagingly, they too often imply that we cannot change our behavior, that in matters of sexuality in particular we are doomed to live dangerously, that we are too weak to do what is best for us.

Thoughtful strategies to change behavior, on the other hand, reinforce the human capacity to recognize and choose what is good. As the Ugandan experience has proved, all people—especially the young—respond to this message when it is sincerely delivered.

The hopelessness at the heart of the risk reduction philosophy is rarely noticed and its effects almost never described or included in the evaluation of the methods for reducing AIDS in Africa. The scientific literature and the popular press instead portray technical, risk reduction measures as the only enlightened and the only truly practical approach to reducing AIDS in Africa. But that reflects a profoundly elitist and patronizing philosophy, which is an insidiously destructive one because people threatened with AIDS most need hope for the future—hope to live free of disease, discord, fear, and inner turmoil.

A colleague of mine in Africa put it like this: “Ideals are like the stars. We may not reach them, but we set our course by them.” If we hope for nothing, as someone has said, we will get what we hoped for. Advocates of risk reduction, though, seem threatened by such an ideal, maybe because it implicitly reproaches the modern autonomy project or seems to support “traditional morality.”

The only real, everlasting solution to the hopelessness the world leaves us with is not simply a change in behaviour. It is a change of heart, a new life in Christ.

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