Brian R Corbin's Reflections on Religion and Life

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Leading HIV researcher Edward C. Green says criticism of the pope ‘unfair.’ Comments?

An interview of Edward (Ted) Green at Harvard by Christianity Today:

 Interview Condoms, HIV, and Pope Benedict

 

Interview by Timothy C. Morgan | posted 3/20/2009 04:27PM

E dward C. Green is one of the world’s leading field researchers on the spread of HIV and public health interventions. He’s the director of the Harvard AIDS Prevention Research Project, and is a leading advocate for evidence-based interventions. He has been sharply criticized by some public health experts for supporting sexual partner reduction programs and for endorsing the so-called ABC method (“Abstain, Be faithful, or use a Condom”) for fighting the transmission of HIV.

After Pope Benedict’s comments earlier this week, Green agreed to answer Christianity Today deputy managing editor Tim Morgan’s questions by e-mail.

Is Pope Benedict being criticized unfairly for his comments about HIV and condoms?

This is hard for a liberal like me to admit, but yes, it’s unfair because in fact, the best evidence we have supports his comments — at least his major comments, the ones I have seen.

What does the evidence show about the effectiveness of condom-use strategies in reducing HIV infection rates among large-scale populations?

It will be easiest if we confine our discussion to Africa, because that’s where the pope is, and that is what he was talking about. There’s no evidence at all that condoms have worked as a public health intervention intended to reduce HIV infections at the “level of population.” This is a bit difficult to understand. It may well make sense for an individual to use condoms every time, or as often as possible, and he may well decrease his chances of catching HIV. But we are talking about programs, large efforts that either work or fail at the level of countries, or, as we say in public health, the level of population. Major articles published in Science , The Lancet , British Medical Journal , and even Studies in Family Planning have reported this finding since 2004. I first wrote about putting emphasis on fidelity instead of condoms in Africa in 1988.

Is there any country worldwide (Brazil or Thailand, for example) that has emphasized condoms where a reduction in HIV infections has been verified and sustained?

In countries where HIV is largely concentrated among prostitutes and their clients, such as Thailand and Cambodia, there seems to have been success in promoting the so-called 100 percent condom policy in brothels. Most analysts credit the decline of HIV infection rates there to this policy and its implementation (of course, they were saying that about Uganda as well), but I agree that this probably has been the major factor explaining prevalence decline in those two countries. However, condom use is not especially high for prostitutes and their clients who are not based in brothels. And another factor in both countries is surely that there was a significant decline in the proportion of men going to prostitutes of any sort, and there was even a big decline in the proportion of men having extramarital sex in the years before we first saw infections decrease in Thailand.

Is there any country in Africa with a high HIV infection rate that has implemented new programs and seen infection rates fall? If so, what strategies are being followed?

I’m glad you asked this. We are seeing HIV decline in eight or nine African countries. In every case, there’s been a decrease in the proportion of men and women reporting multiple sexual partners. Ironically, in the first country where we saw this, Uganda, HIV prevalence decline stopped in about 2004, and infection rates appear to be rising again. This appears to be in part because emphasis on interventions that promote monogamy and fidelity has weakened significantly, and earlier behavior changes have eroded. There has been a steady increase in the very behavior that once accounted for rates declining — namely, having multiple and concurrent sex partners. There is a widespread belief that somehow Uganda had fewer condoms. In fact, foreign donors have persuaded Uganda to put even more emphasis on condoms.

What about Swaziland, which has a reputation for one of the highest HIV rates in the world? Do condoms work there? If not, what would?

As I have said, condoms have not worked in any country in Africa. The two countries with the highest infection rates, Swaziland and Botswana, have both launched MCP campaigns. “MCP” is shorthand for campaigns that discourage people from having multiple and concurrent sexual partners. We are starting to see prevalence decline in both of these countries.

Is the African church part of the problem here for creating a stigma and demonizing people with HIV?

That charge has been way overblown. There was some of that early in the pandemic, but the churches’ involvement and intervention are essential. For one thing, they have always been right about where to put the emphasis — namely, on marital fidelity and abstinence, or delay of the age of first sex. All faith-based organizations promote this, whatever the denomination or religion. Faith-based organizations are some of the most powerful NGOs in Africa, and they play a leading role not only in general health and education in these countries, but also in caring for the sick and dying in the AIDS epidemics we find in Africa, from the very beginning. I think historians will look back and find great fault in the fact that the major AIDS donor organizations did really not bring the religious groups into prevention activities at or near the beginning of the pandemic.

What is the best HIV prevention strategy for the Obama administration to fund with new PEPFAR money?

Well, my views here also upset a lot of my colleagues, but I’ve always said that we cannot treat our way out of this pandemic. A sound public health approach is always based on good prevention strategies. We can justify treatment with expensive anti-retroviral drugs on humanitarian grounds, but it’s hard to do on public health grounds. So I would advise Obama, the candidate I voted for, to put more emphasis on prevention, and to face up to the hard realities of the best evidence available to date, which shows that condom promotion, testing and counseling, curing the curable STDs, or any of the other interventions widely endorsed and considered “best practices” always funded have simply not worked in Africa. (It’s possible they may work in other regions, like condoms in Thailand, so it’s easy for me to be misquoted on something like this.) In a number of studies, these interventions have actually been shown to not work. The two interventions that work best in Africa are promotion of monogamy and fidelity, and male circumcision. We have even stronger science behind the latter. I assume people know about “the male circumcision factor” these days, so I will not say more here.

As for IDU (injecting drug use) epidemics, I would advise putting resources into preventing addiction in the first place and into treatment of drug addicts and facilitation of support groups to keep addicts from relapsing, groups like those following the 12-steps.

Filed under: AIDS

Operation Rice Bowl Continues: week 4 of Lent

Fourth Week of Lent: Solidarity Will Transform the World

Honduras

Located in Central America, Honduras is a resource-rich country that also struggles with the devastating effects of tropical storms and political conflict. More than one-third of the workforce is in agriculture, most as subsistence farmers. Through its Natural Resource programming, Catholic Relief Services helps farmers, like Martín Reyes Granados, to develop sustainable methods of farming, increasing their yield so they can sell their surplus.

Pray

What do we see when we look at the world with the light of Christ? We see a world so beloved by God that God entered our human existence in order to dwell in it with us. We see a world that sings of the presence of the divine, in its abundance, its beauty, its creative genius. And we see a world that continues to suffer as it waits for the peace, justice and common good promised in God’s reign. As Nicodemus discovered when he visited Jesus under the cover of darkness, if you want to associate with the Son of God, you have to be willing to walk with him into the light of day and get to work. In your prayer this week, express your gratitude for the many blessings that God has placed in your world. At the same time, reflect on the work that is still to be done, the suffering and need that occur right before us in the light of day. Ask God to give you the courage to respond with the compassionate light of Christ.

Fast

People are not the only ones to suffer from injustices, from imbalances of power, from conflict and greed. The earth suffers too as it is worked in ways that are not sustainable, as it is deforested, eroded, poisoned and paved over. This week, let your fast express care of the earth. Fast from foods that are produced in wasteful or inhumane ways and instead eat foods that are produced locally using sustainable and ethical methods. Fast from modes of transportation that pollute and waste resources, and instead walk, bike, carpool or take the bus. Fast from purchasing items that are over packaged, and instead bring your own bags to the grocery store or buy used items from a local non-profit thrift store. Fast from purchasing items that are produced using unfair labor conditions, and instead purchase items that are certified as Fair Trade.

Learn

Martín Reyes Granados learned he did not have to go it alone as a small subsistence cattle farmer living in Estancias, Honduras. By attending the CRS-sponsored Country School for Small Farmers, he found himself in a network of support and learning that helped him to change his farming practices and improve his entire agricultural community. The school teaches small farmers to learn from one another and share experiences and experimentation. After joining the school, Granados went from owning a small herd of cows that barely produced milk to running a small but productive dairy farm. Today he is working to improve his community and region as the president of a local dairy co-op and a member of the Fair Trade Network in Honduras.

Give

This week, free up some money for your Rice Bowl while implementing some cost-saving green principles in your own home. Here are several suggestions: * Instead of purchasing paper towels to clean up messes, cut up several old towels and t-shirts to make a pile of rags to keep in the kitchen and bathrooms. Drop them into a basket after you’ve used them, so you can wash and reuse them. Need a little extra scrubbing power? Wrap a rag in a plastic mesh fruit bag, the kind that oranges come in. These can be reused over and over again.

* Instead of purchasing window and counter cleaner, put a mixture of equal parts water and vinegar in a spray bottle. You can use this everywhere, from sinks to counters to windows. For your windows and mirrors, use newspaper instead of using paper towels.

* Instead of buying powdered cleansers, pull out the baking soda and the borax for a little extra scrubbing power.

* Instead of throwing the laundry in the drier with softening sheets, hang it outside to dry and to be freshened by the sun.

Put the money that you didn’t spend into your Rice Bowl this week.

Monies collected from Operation Rice Bowl, collected in the parishes during Holy Week, are split between local (25%) and international (75%) efforts.  The local amount remains in the Diocese of Youngstown for small grants to parishes and groups working to relieve hunger.  The 75% goes to Catholic Relief Services to provide humanitarian and long term development efforts around the world.  Thanks for your generosity.

Filed under: consumerism, Culture, Market Place, Personal Reflections, Social Justice, Spirituality

Lenten reflections from Catholic Charities leader: St Patrick’s day

Tuesday of the Third Week in Lent

March 17, 2009

Readings: Dn 3:25, 34-43, Ps 25:4-5ab, 6 and 7bc, 8-9, and Mt 18:21-35

Psalm 25 contains one of my favorite verses, “Guide me in your truth and teach me, for you are God my Savior (5).” I love this verse because it truly illustrates to me the character of King David, author of this passage. David was a man seeking after God’s heart. And although David was not perfect, what is so beautiful about David is how you can hear throughout the Psalms him calling out to God. He desires for the Lord’s ways to be his own ways, for his path to be the Lord’s path, and his truth to be the truth in Christ.

This is something that should cause all of us to stop and reflect. Are we seeking after God’s heart? My Catholic Charities family, I know how very busy and stressful these times are for us. We are being asked to do more with less and are seeing so much pain with the families we serve. However, our first call is to God by spending time with Him in fellowship, prayer, and study. When we seek His heart, all else falls into place.

Lent calls us to focus on the incredible gift God has given us. And when we focus on being men and women after God’s heart, all who we meet and serve will sense it. This is when we truly become a beacon of hope in our communities.

Heather Reynolds

President/CEO

Catholic Charities, Diocese of Fort Worth, Inc.

hreynolds@ccdofw.org

Filed under: Personal Reflections

Making Peace in our lives……


Twenty-six years ago our Bishops informed us that “Peacemaking is not an optional commitment. It is a requirement of our faith. We are called to be peacemakers, not by some movement of the moment, but by our Lord Jesus.” (The Challenge of Peace, par. 333.)

The message of Jesus and the teachings of our church are calling us to become a peace-building church. This is not an easy task in a world scarred by violence and terrorism.

As we journey through Lent how are we working to build peace between diverse groups, and among nations? How are we becoming disciples of the nonviolent love of Jesus?

How can this Lent be a time a deeper spiritual peace for me so that I can be a more peaceable person?

(from Diocese of Rochester)

Filed under: Personal Reflections

Catholic Charities Lenten Reflection: March 10


Tuesday of the Second Week in Lent

Readings: Is 1:10, 16-20, Ps 50:8-9, 16bc-17, 21 and 23, and Mt 23:1-12

These passages contain strong language including the exhortation to listen, when, if anything, a part of me wants to skim over these verses to something less discomforting. So, first of all, I need to ask the Lord to help me to listen. I hear Him admonishing me for the very human propensity toward hypocrisy: being phony; portraying an image of myself that is better than the true condition of my heart; trying to appease God by complying with His rules when my heart wants to do otherwise. Stated positively, these verses bid us to be persons of integrity: to be genuine; persons in whom there is no deceit or pretense.

In addition, these passages impress upon me the need for balance in my Christian walk – balance between inner piety and outer manifestations of my faith. Growing up, I was taught Is.1:18, but only as it pertained to my inner life. Looking at this verse in its context, we see that the exhortation is not only to having a clean heart, but also to demonstrating God’s love through compassion, clemency, good deeds, fair dealings, and hospitality toward the less fortunate. Later, I discovered James 1:27: “Religion that is pure and undefiled…is this: to care for orphans and widows in their affliction and to keep oneself unstained by the world.”

Lord, help me be a person of integrity and to live a balanced Christian life; to be equally attentive to my inner life and the outward manifestation of your love.

Paul Moceri

Program Manager

Quality Assurance Specialist

Treatment Foster Care

Commonwealth Catholic Charities

Norton, VA

Paul.Moceri@cccofva.org

Filed under: Personal Reflections, Spirituality