Preventing STIs

I am fascinated by the rather poetic comparisons used by some correspondents (what with Russian roulettes and getaway cars), when discussing condoms. It would be amusing if the subject under discussion - the prevention of AIDS - were not such a serious matter.

We can all quote the sources that please us best and conform to our own beliefs and foibles.

The facts are that the overwhelming medical consensus backed by solid research is that in the prevention of sexually transmitted infections (STIs) (including HIV/AIDS) what is needed is the ABC propagated by WHO and UNAIDS.

A abstinence.
B be faithful.
C condoms.

All three components are equally important. The use of one does not preclude the use of the others.

The contention that the use of condoms encourages risky behaviour is false. Equally the claim that the teaching about safer sex (there is no such thing as safe sex), encourages earlier experimentation goes against all accepted scientific research. On the other hand, the message of abstinence by itself is associated with earlier experimentation. When discussing condom failure rate, the fact is that the cause of condom failure is... condom non-use.

A very recent campaign attempted to discourage the use of condoms by claiming that condoms have microscopic pores which allowed the passage of viruses anyway, so why bother. This has been condemned by all leading medical authorities, including the European Commission, which has funded research that proves the very contrary.

Am I suggesting that the use of condoms allows us complete sexual freedom? Most definitely not. Condoms by themselves are not enough.

All persons involved in the prevention of sexually transmitted infections that I know and work with never suggest that condoms are the answer to all our ills; we do need abstinence and fidelity primarily. But it is wrong and morally indefensible, in my opinion, to exclude the use of condoms just because we might personally "not like them" for whatever reason.

Prevention campaigns do have limited success. But we need to keep in mind our limitations, in that we can only influence human behaviour so much, especially when dealing with the all-powerful sexual drive. Our duty is to prepare our youngsters by giving them all the facts, empowering them to make, hopefully, the right decisions when they decide that the time has come to start on a sexual relationship. Equally we must make sure they are aware of their responsibilities.

It is a fact that, if we all had sex within marriage alone, than we would not have a problem with the STIs. But the reality is different. People do (and always have) have sex outside marriage. So do we give up on them because they cannot live to our own "high standards"?

Incidentally, the much higher rate of HIV prevalence in Sub-Saharan Africa is a complex matter and the role of contaminated medical equipment, apart from sexual spread, has yet to be resolved.

Why is it that in Malta we seem to have a periodic "condom season" when we do our best to discredit its use? This in spite of all the evidence that the condom, properly used, does have a vital role to play in the prevention of STIs. The medical references are too numerous for a newspaper; anybody interested can contact me at the GU Clinic at Boffa Hospital.