Ugandan President Yoweri Museveni began the debate, telling participants that he thinks policies that promote abstinence and sex within marriage are more effective at preventing AIDS than policies that stress condom use alone. "[In the first instance, practice] abstinence, be faithful to each other...but if you can't, use the condom," he said.
Museveni put his finger on one of the most divisive issues in the anti-AIDS community today: whether and how much to stress sexual abstinence in the overall fight against HIV/AIDS.
In the past, international anti-AIDS policies have focused on promoting the use of latex condoms, which prevent the transmission of the HIV virus that causes AIDS. Such programs -- as well as other safe-sex techniques and better AIDS awareness -- are credited with limiting the number of new HIV/AIDS infections in the United States and Western Europe. Similarly, in Thailand in the 1990s, a program promoting 100 percent condom use is seen as preventing some 200,000 new HIV/AIDS infections.
But condom programs have fallen out of favor among conservative governments, which fear such policies promote promiscuity and fail to deal with what they see as a root cause of AIDS.
Museveni's country, Uganda, in recent years has seen a decline in the number of new HIV/AIDS cases. It's not clear why AIDS appears to be subsiding in Uganda while infections are increasing in much of the rest of Africa. But some say Museveni's "ABC" policies should get the credit. ABC stands for "Abstinence," "Be faithful" and "use Condoms where appropriate."
U.S. President George W. Bush has put ABC at the center of a $15 billion U.S. effort to fight HIV/AIDS. A third of U.S. anti-AIDS funds must now go toward programs that promote sexual abstinence until marriage. This has put the Bush administration at odds with many mainstream anti-AIDS groups. They say abstinence programs wrongly place morality at the center of the anti-AIDS effort.
What's more, they say, abstinence programs are unrealistic, especially since in many countries the populations most at risk -- women and girls -- are not in a position to choose their sexual partners. U.S. Congresswoman Barbara Lee made that argument today in Bangkok.
"Programs that deny education about, and access to, condoms ignore the realities in which women and girls live in many, many countries throughout the world. It's a reality that abstaining from sex often times is not a choice and, therefore, [the] only hope at preventing HIV infection is the use of condoms," Lee said.
Lee said abstinence-only programs are, in her view, inhumane. "In an age where 5 million people are newly infected each year, and women and girls too often do not even have the choice to abstain, an 'abstinence until marriage' program is not only irresponsible but is really inhumane," she said.
In 23 years, AIDS has claimed more than 20 million lives and threatens 38 million more who are living with HIV, the human immunodeficiency virus that causes AIDS.
The AIDS conference, held every two years, runs through this week. The UN conference is aimed not only at scientists and medical professionals, but also serves as a forum for international AIDS policies.