HIV/AIDS: Sex, Abstinence, and Behaviour Change

Adapted from author

"This opinion piece, published by Lancet Infectious Diseases, argues that an abstinence approach to HIV does not take into account the balance between contextual and environmental factors and individual choices in determining why and how people have sex. The article reviews the case of Uganda, where many claim that the ABC approach (abstinence, be faithful, condoms) helped to maintain low HIV prevalence rates early in the epidemic. The authors highlight that this was only one of many messages and there is no evidence of any causal link between any single message and the behaviour change observed.

The authors argue that abstinence-based prevention messages fail to engage with diversity and the social and economic contexts of sex. Focusing on education alone may not be appropriate as sex in [economically] poor country contexts is more often tied to livelihoods, duty and survival. In order to address the HIV epidemic, sex must be seen for what it is, rather than what we assume it to be from the assumptions of our own cultural standpoint. Continued misunderstandings of the nature of the problem, based on incorrect assumptions about the drivers of other people’s sex lives will result in a waste of resources on inappropriate policy recommendations and interventions."

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