Bush's policy for fighting AIDS comes under attack

By VIJAY JOSHI
The Associated Press

E-mail this article Print this article Search archive Most read articles Most e-mailed articles

Ugandan President Yoweri Museveni was the only big-name speaker at the International AIDS Conference to support the Bush administration's ABC policy: abstinence, being faithful and condoms, in that order.

Museveni said loving relationships based on trust are crucial, and "the principle of condoms is not the ultimate solution."

"In some cultures sexual intercourse is so elaborate that condoms are a hindrance," he said. "Let the condom be used by people who cannot abstain, cannot be faithful, or are estranged."

Uganda has waged a successful battle against HIV in a rare success story for sub-Saharan Africa — down from more than 30 percent in the early 1990s to about 6 percent last year — though some experts say it's unclear how the success has been achieved. Museveni credited abstinence.

U.S. Rep. Barbara Lee, D-Calif., and other delegates urged rich countries to spend more on condoms and other HIV-fighting programs for the developing world.

"In an age where 5 million people are newly infected each year and women and girls too often do not have the choice to abstain, an abstinence-until-marriage program is not only irresponsible, it's really inhumane," Lee said.

Proponents say there is no better way to prevent HIV than by using condoms and giving clean syringes to intravenous drug users. The Bush administration maintains that emphasizing condoms promotes youth promiscuity.

Condoms have been promoted as a front-line defense against AIDS by countries such as Thailand, where a campaign to get sex workers to insist on condoms yielded a more-than-sevenfold reduction in HIV rates in 13 years.

In related developments at the conference:
 

• The two-decade search for an AIDS vaccine is all but starting over, researchers said, noting that the only vaccine to complete two large-scale clinical trials, AIDSVAX, proved a flop. In addition, they said, most of the 30 vaccine candidates now in the pipeline are relatively untested, and they're so similar that if one fails, they all may fail.

"This is a global disgrace," says Seth Berkley of the nonprofit International AIDS Vaccine Initiative. "There hasn't been a serious effort (to develop a vaccine), and until there is a serious effort, we'll never get there."

• A new generation of U.S. gay and bisexual men is engendering a sharp increase in the number of newly diagnosed HIV cases, as the very drugs keeping them alive have encouraged risky sexual behavior, researchers said.

The number of new HIV cases diagnosed in the U.S. jumped 17 percent among gay and bisexual men from 1999 through 2002, compared with a 7 percent increase among men overall, according to a 29-state survey.

"Sure it's irrational; people do a lot of things that are irrational," said Dr. Jeffrey Parsons, an AIDS researcher at New York University who documented an increase in unprotected anal sex.

• A potential trade agreement between Thailand and the United States could derail Thailand's production of inexpensive AIDS drugs and imperil the future of an anti-HIV program that is widely considered a model for Asian countries, the group Doctors Without Borders said.

"If the Thais sign such an agreement, they will have to close down their generic drug production," Paul Cawthorne of the Belgium-based group told a news conference.

Thailand is one of the few countries — others include India and Brazil — that manufacture generic versions of anti-HIV drugs developed by U.S. manufacturers. A free-trade agreement, meant to expand business exchanges between the U.S. and Thailand, would incorporate language reinstating the patents on the drugs in an effort to protect U.S. drug companies. The Bush administration has argued that the generic versions of the drug are potentially unsafe and that they are not as effective as the branded versions, a claim most experts dispute.