It has been revealed at a conference in Nairobi that 60% of all new sexually transmitted infections, including HIV, occur in those aged 15-24. These are the very people who should have received, and should still be receiving in the case of those in their mid teens, the latest HIV prevention programming. The authors of the report even suggest that there may be significant under-reporting of risky sexual behaviour.
The report calls for a 'more aggressive' educational approach, whatever that may mean. In a separate article on back street abortions in Kenya, there are some worrying remarks on sex education. Aside from concentrating on abstinence, often to the exclusion of anything else, teachers who are trained in teaching sex education are under no obligation to teach it. There is no specific time set aside for them to do so and many parents would prefer teachers not to teach their children anything about sex.
Kenya has spent over 20 years resisting the call to teach their children and adults about sex, safe sex, family planning, maternal health and health in general. In particular, they have resisted advice to promote the use of condoms to prevent HIV, other sexually transmitted infections and unplanned pregnancies. The multiple uses of condoms need to be stressed.
The repeated calls for abstinence, however dressed up in pointless slogans, are useless. Years of sexual transmission of HIV, other sexually transmitted infections and unplanned pregnancies show that these 'prevention' programmes have not worked. Unfortunately, the latest National Aids Strategic Plan has little new to suggest to prevent HIV from being transmitted and it still only allocates about 30% of HIV/Aids funding to prevention. But no amount of money will make a difference if abstinence is the best they can come up with.
Countries with high rates of HIV transmission seem to be obsessed with abstinence campaigns, which have had no impact and will continue to have no impact. Telling young people that it is worth their while waiting till they are married is simply lying in the face of evidence that many people become infected by their spouse. They need to be told about the dangers they face and given ways to avoid those dangers. If condom use is the best we've got right now, we owe it to people to promote the use of condoms.
Those who object to abortion, HIV, sexually transmitted infections, promiscuous sex, unsafe sex, sexual abuse and various other things that they rail about need to embrace comprehensive sex education for everyone, young and old. Denying the existence of risky practices, commercial sex work, men having sex with men, intravenous drug use and the rest is not going to make it go away. Moralising about it and saying how bad it all is will not make it go away either.
It's very hard to legislate over people's sexual behaviour. And even behaviour that is illegal will occur, despite the threat of punishment. The least the Kenyan government can do is to reduce the amount of harm people are currently being exposed to. Many Kenyans are now experiencing the consequences of not implementing harm reduction programmes, such as the widespread promotion of condoms, decriminalisation of commercial sex work and same sex relationships, needle exchange programmes and even family planning services that would support people who end up pregnant against their wishes. People need to be protected from harm, not punished for being harmed.
Wednesday, October 21, 2009
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