Re: Condom Bar - 'ineffective' way to tackle AIDS

[Guest guest]

Dear Forum,

It is unfortunate that ignorant journalists and people claiming to work on AIDS

should come together and malign an effort that has truly broken the barriers

surrounding discussions on condoms.

This article only reflects the fact that the writer and other people quoted in

it are stuck in time - to be precise, about 10 years back - with regard to

effective HIV prevention strategies. It has been recognised world over that

USAID's policies regarding HIV prevention as well as reproductive health and

rights are driven by a condervative right-wing agenda through the Bush

government.

There has been research and evidence to show that the ABC approach is failing

all over Africa and even the US (refer:

http://www.guttmacher.org/media/nr/2007/05/23/index.html;

http://www.ippf.org/en/Resources/Articles/Alternative+to+ABC.htm

; http://www.kff.org/youthhivstds/1560-index.cfm).

However, our Indian government workers and other 'development professionals'

are, as usual, removed from the global discourse and seem to think that as long

as people do not have sex, the problems of the world will be solved!

If it was really as simple as abstinence and being faithful then India would not

have a population of over a billion, 30 million women in the country would not

be experiencing pregnancy annually, infection

rates among women would not have accounted for 25% of all cases in 2004 and

would not have been rising among married women

(http://www.pepfarwatch.org/pubs/GenderHIV.pdf).

Findings from a couple of small sample studies would not be suggesting that

within married women, 80% of infections were among women who were married and

monogamous!

Wake up to the facts! Wake up to the reality of life in all its sordid sexiness!

Since when did abstinence start protecting the 45% of girls married before the

age of 18 and exposed to society sanctioned rape at the hands of (usually) an

older, possible sexually

experienced male?

So we are talking about the 'upper and middle class' of society and therefore

may not need to worry about child marriage? How many HIV interventions target

the ever-increasing young people in corporate jobs, call centres, etc. with the

time and money to spend on leisurely pursuits, including frequenting bars? How

many of the country's bars, pubs and nightclubs offer a safety option to these

young people (who are fast becoming the economic backbone of the country) out to

party hard every weekend after a hard week's work? One

assumes that being educated and having access to different kinds of media, they

would be aware and conscious of HIV or STI risks. Is there any real research

that shows this awareness?! My own friends

claim ignorance on STI and HIV.

Yes, HIV is a serious issue and therefore must not be open to the political

agendas and vested interests of the W. Bush's of the world. If we are so

quick to castigate 'western influences' on the young people of our country, how

come we are happy to lap up the

rotten policies on HIV prevention bandied about by the US? As development

workers, as people committed to the cause of HIV prevention, we certainly need

to be up-to-date on all the strategies, research, evidence and political agendas

surrounding HIV before attacking efforts like the Condom Bar in Chandigarh that

mirrors

the political will shown by Senator Mechai in Thailand.

Cabbages and Condoms, in Thailand, has shown results in HIV prevention

(http://www.gatesfoundation.org/GlobalHealth/Announcements/Announce-070529.htm)

that could not have been achieved without being open

about condoms and the fact that they are probably almost as important a part of

our lives as is food.

I also think it is hilarious that the same USAID, quoted in the article,

launched the 'Condom Bindaas Bol!' campaign with the Ministry of Health and

Family Welfare

(http://topics.developmentgateway.org/hiv/rc/ItemDetail.do?itemId=1075510).

It just goes to show the schizophrenic policies adopted by policy-makers who may

personally recognise the threat of not being able to talk about or access

something as basic as condoms but are weighed down by a vote-bank and political

donors who are perceived to

be right-wing, fundamentalist and downright conservative. Of course, data shows

otherwise, but the South Asian sense of 'honour' means that the 53% of children

who have suffered one or more forms of sexual

abuse are well hidden (www.wcd.nic.in/childabuse.pdf).

If their was a research on the 'prevalence of faithfulness' within marriage, I

am sure we would find the answer to the 'mystifying' fact that less than 1% of

HIV positive women are sex workers - the majority

of them are monogamous housewives. Thanks to the fact that these women abstained

till marriage and were faithful to their husbands and two-thirds of them didn't

even know that consistent condom use can reduce the chances of getting HIV

(http://www.nfhsindia.org/summary.html).

“Women are not dying because of diseases we cannot treat...they are dying

because societies have yet to make the decision that their lives are worth

saving.” Dr Mahmoud Fathalla, Professor of Obstetrics and Gynaecology, Assiut

University, Egypt

Like I said - wake up!

Arushi Singh

e-mail: <dawnlion@...>

[Guest guest]

Dear FORUM,

How do we say that having condoms in the bar is gimmickry?

Let us remember that thailand achieved almost 100 % use of condoms by such

gimmickry. No one denies that ABC components must be applied in composite

fashion but the importance of ABC strategy does not decline in importance by

'condom bars'.

Lalji K Verma

e-mail: <lkv2005@...>

[Guest guest]

Dear Forum,

It is heartening to note the comments of Arushi Singh. I totally agree with her.

Theese kinds of initiatives must be supported instead of criticising without

scientific evidence.Use of condoms must be popularised in the fight against

HIV/AIDS. And this is one potent way of doing it.

In fact, all roadside dhabas, truck drivers' harbours should be encouraged to

have condoms readily and freely available.

Air Mshl Lalji K Verma AVSM (Retd) MBBS M Sc (E & E) FRSA

253, AFNO Enclave, Plot-11, Sector-7

Dwarka, New Delhi - 110075

Tele- +91-11-25094702 (Res), +91-11-28032767 (Work),

+9312626462

e-mail: <vermalk@...>

[Guest guest]

Dear Forum,

First of all, I question the tagline. It goes like this: Study: CITCO's Condom

Bar - 'ineffective' way to tackle AIDS. And then the first line that further

waxes eloquent about the lack of 'scientific' ABC approach.

In my opinion, firstly, a newspaper article cannot constitute a study.

Secondly, we are talking about a bar! Not a programme to tackle AIDS.

Thirdly, there is very little 'scientific' about the ABC approach.

It's a behavioural model or in other words, a guideline conjured up by so-called

communication experts (I still consider myself a learner) and then made snazzy

(read 'buyable') by more of our kind.

Now, I do not question the motives and intentions for such guidelines. The only

trouble is that we really seem to be out of focus about what is *relevant* and

*do-able** *in the CURRENT scenario!

Carpet-bombing decade-old concepts of communication cannot be the answer to the

different issue-based and contextual needs of today. Of course, there is ample

evidence that the ABC method is not really as effective as the moral brigade

want it to be. Just a few weeks ago, I personally witnessed a senior health

official extend it to ABCD –'Abstinence, Be faithful, Condoms… or Die!'... in a

public meeting.

This, at a time where prevention efforts of the past have been recognised as

stigmatising and major efforts and resources are required just to fight stigma –

leave alone the virus itself.

It is widely accepted that a lot of the stigma faced by HIV + people is a result

of insensitive and non-inclusive communication campaigns.

Another point to ponder is ownership by those who work in prevention. At some

point or the other, our faculties are so clogged with information that despite

all the good intentions and sensitivity, each one of us assume the 'expert' role

with our own sense of 'correct' and 'incorrect'. A case in point is the condom

bar. What appears as a genuine, unique, even out-of-the-box & bold move to some

might be labelled as 'gimmickry' by others. Is it because we only see the

'serious' side of the situation bordering on the diabolic? Hence, are we only

looking for 'serious' solutions? Does that not make the whole effort doubly

bleak and seemingly insurmountable? What about the fun element? How do people

win over cancer with nothing but a positive outlook?

My personal experience with thousands of truckers has demonstrated that even the

most hard-nosed, 'macho man' can reason and make 'safer' choices in a fun

environment. And an enabling environment is a fun environment for long-term

behavioural decisions.

Let's get back to the bar. It's a bar to promote condoms. And a perfect place to

think and talk about sex. It's not a condom outlet alone. So just the number of

condoms that are given out may not do justice to the impact that it may have on

visitors. In addition, the publicity generated will also have people talk about

condoms and safer sex among other peers.

Finally, this whole hullabaloo has turned into another moral brigade story. It

is ironic that Mr. Bir considers the newspaper and its reporter a better expert

on HIV & AIDS communication than the HIV & AIDS experts themselves.

The fact that no experts or customers objected to the displays in the bar, in my

opinion, is telling (see:

http://epaper.hindustantimes.com/artMailDisp.aspx?article=28_06_2007_162_015 & typ\

=1 & pub=722).

Sadly, the virus has no moral or immoral considerations.

So friends, as long as such trivialities are hailed as 'impact', any real impact

just cannot come through.

Sameer Thakur

Development Communication Consultant

e-mail: <mail2sameerthakur@...>

[Guest guest]

Dear FORUM,

In the ABCD of HIV preventon, " D " must stand for the Dignity of Partner.

Treating women & girls as sex objects for pleasure & then discarded, burdened

with all the consequences of the act, where the immediate gratification of the

Sex Act is given greater priority over building relationships which give

happiness to both, & are safer & sustainable.

Condom contributes to prevention of pregnancy & infection, but the need for

gender sensitization in this unequal power relation excercize needs to be

addressed . The Jhansi phenomenon of what the bar girls are having to do when

options of what they consider dignified work close, this phenomenon is also

going to increase

Please, also note on the sanction of the " Rest & Recreation " excercise in

Chennai Port by the US Navay & its implications

Dr Mira Shiva

e-mail: <mirashiva@...>

[Guest guest]

Dear All,

I would like to reiterate the ideas expressed by Dr. Amar singh and

Dr.Jolly. Although I have not seen the CIDCO materials on Condom

Bars. I would like to state here that by promoting condoms alone for

the prevention of HIV/AIDS our job is incomplete, we must promote

the ABC strategy with more emphasis on the A & B. It should also be

mention that condoms are not 100% safe, they can slip and tear and

in the past have resulted in unwanted pregnancies.

Just by promoting condoms the users are getting a false sence of

security. I would like to quote a real incident here. Last week an

engineer student came for checking his HIV status. On being

questioned about the high risk behaviour he mentioned that he had

visited a CSW about 8 months back. On being enquired why he came

late for testing?, he mentioned that he was not concerned about it

earler as he had used condoms. Now he had come for testing as he

felt that there were some changes in his skin.

I think it is time we also start refining our messages.

Dr. Rewa Kohli

e-mail: <rewamkohli@...>