The Instigator
Procrastarian
Con (against)
Losing
0 Points
The Contender
Puck
Pro (for)
Winning
21 Points

The Widespread Distribution of Condoms in Africa is in Africans' Best Interests

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Voting Style: Open Point System: 7 Point
Started: 2/27/2010 Category: Society
Updated: 7 years ago Status: Voting Period
Viewed: 4,111 times Debate No: 11286
Debate Rounds (4)
Comments (9)
Votes (4)

 

Procrastarian

Con

I would like to debate someone who is willing to put thought into this debate. I request that all arguments be at least 1,000 characters (1/5 of the cap) in length. I would also like to avoid semantic disputes surrounding the resolution. This debate is about the mistake countries have made and continue to make by spending millions on condoms to send to African countries.

Arguments
I will begin by outlining my arguments. Once I see which parts my opponent contends, I will elaborate on those specific parts.

1. The distribution of condoms harms women by taking away a major tool they have for protecting themselves against undesired sexual pressures. In African society, a man who impregnates a woman is considered responsible for protecting and supporting the child. This allows women to use this risk of responsibility as a defense. Condoms invalidate this by vastly decreasing the probability of pregnancy. They also make men feel less responsible for any children created during sex while using condoms because condoms give a false sense of security against pregnancy.

2. Condom distribution doesn't significantly decrease HIV/AIDS. It's likely that they don't even reduce the prevalence of these diseases. Countries in which condoms have been widely distributed for years are still dealing with HIV/AIDS epidemics. Hundreds of thousands of Africans still die each year because of AIDS.

3. Condom distribution can increase the prevalence of AIDS. If people think that they can have risk-free sex by using a condom, they are likely to have sex more often and with a greater range of partners. Although condoms have a high success rate, it's still imperfect. If people have sex more often because they have condoms, it's possible that the increase in sexual activity will override the intended disease preventing effect of increased condom usage.

4. The money spent on distributing condoms could be better spent on education about abstinence and HIV/AIDS for African countries. Although the sex using condoms is less likely to spread HIV than sex not using condoms, not having sex at all decreases the chances by an enormous factor. If our current efforts being channeled into condom distribution were largely shifted into efforts to discourage polygamy, prostitution, sex before marriage, and sex with multiple partners, we would be much more likely to attain the desired result of reducing the harm caused by HIV/AIDS in Africa. Instead of encouraging more sex in an HIV/AIDS infused culture through widespread distribution of condoms, we should encourage more abstinence and monogamy. Even if my opponent can show that condom distribution actually does decrease HIV/AIDS, my opponent must also fulfill the burden of showing that resources being diverted from condom distribution to abstinence/HIV/AIDS education wouldn't be a more effective means of dealing with Africa's HIV/AIDS problem.

Thank you. I hope this will be a good, informative debate.
Puck

Pro

Argument 1.

Con claims that women are generally pressured to have sex and that condoms will lead to more cases of rape (the argument is not explicit). The alternative, fewer cases of consensual sex is not supported by his premise. Consensual sex requires, not surprisingly, consent. If the sex is consensual then arguments about condoms as a mitigating factor are void. Con is left with availability of condoms promotes rape. An unsupported base claim. In fact African women themselves are promoting condom use.

http://www1.voanews.com...

Men feeling less responsible, again unsupported - research? That children conceived from condom users suffer from parenting styles as opposed to those children not, also unsupported.

Argument 2.

Con argues that condom use is unlikely to reduce the transmission of HIV/AIDS. Research states the opposite.

Con makes the fundamental error that advocacy of condom use exists in a vacuum. That is, with the distribution of condoms little else in the way of harm reduction occurs. Very few programs run in this manner; most use sex education alongside the distribution of condoms. This is an important point to maintain. Con is arguing for the removal of a salient piece of technology that can reduce transmission risk. When programs are in place that deal with harm minimisation, the removal of any component can fundamentally undermine the entire structure and success of the program. Con needs to make the case of, in those areas where programs are run where harm minimisation includes education of safe sex practices, the drive for later onset of first time sexual intercourse and reduced polygamy - why the removal of condoms - a key factor in the reduction of the spread of disease and pregnancy - should be seen as valid. It makes no sense to remove a successful, unique portion of a program and expect the program to run with greater results.

Studies in Thailand and China has shown that mass distribution of condoms along with education significantly reduced the incidences of HIV/AIDS. Similar programs in Africa and America have had positive results. [2][3][4][5]

http://www.who.int...

Argument 3.

Next Con argues that condom availability will lead to greater transmission (more sex) and promote polygamy. Con needs to show that abstinence would be/has/is greater in countries where such programs aren't run and where incidences of HIV/AIDS are high (research). In the Caribbean where programs are less available the prevalence is high (around 2% of the general population - ranking the region 2nd in the world). It simply doesn't follow that population prevalence equals self monitoring abstinence in those populations.

The second part is that condom usage will create cases of HIV/AIDS at a greater rate. In addition to what has been already listed, studies of discordant couples where proper condom use is maintained find transmission to the partner is extremely rare. [6]

Argument 4.

The amount of research against abstinence is large. A study of declining HIV prevalence in Uganda found no evidence that abstinence or monogamy had contributed to the decline. [4]

In the U.S. the results are the same - abstinence education does not achieve its goals. It does not reduce prevalence of sexual encounters, age of onset of first time sexual intercourse nor reduction in partners. Positive intent towards abstinence does not correlate with behaviour at all. [7] [8] [9]

Cons arguments are largely baseless and contradict research. The proposal to remove a necessary component in harm reduction whilst having sex is at best misguided.
==
[1] http://www1.voanews.com...
[2] Weller. S. C. A meta-analysis of condom effectiveness in reducing sexually transmitted HIV. Soc Sci Med, 36 1635-1644
[3] CDC. Condoms and Their Use in Preventing HIV Infection and Other STDs. Atlanta, GA: CDC.
[4] Wawer MJ et al. Declines in HIV Prevalence in Uganda: Not as Simple as ABC. Presentation at the 12th Conference on Retroviruses and Opportunistic Infections, February 22-25, 2005.
[5] de Vincenzi I. A longitudinal study of human immunodeficiency virus transmission by heterosexual partners. New England Journal of Medicine 1994; 331:341-346.
[6] Weller SC & Davis-Beaty K (2007), 'Condom effectiveness in reducing heterosexual HIV transmission
[7] Kirby D. Emerging Answers: Research Findings on Programs to Reduce Teen Pregnancy. Washington, DC: National Campaign to Prevent Teen Pregnancy, 2001.
[8] LeCroy & Milligan Associates. [Final Report, Arizona Abstinence Only Education Program Evaluation, 1998-2003]. Phoenix: Arizona Dept. of Health Services, Office of Women's and Children's Health, June 2003
[9] Barnett JE and Hurst CS. Abstinence education for rural youth: an evaluation of the Life's Walk program. Journal of School Health 2003; 73: 264-268
Debate Round No. 1
Procrastarian

Con

My opponents main contention is that abstinence and monogamy education fails while condom distribution and education succeeds in decreasing the prevalence of AIDS. I will therefore focus my arguments on this point. I will argue that promoting abstinence and only one sexual partner at a time is a more effective use of limited resources than distributing condoms to the general population.

To begin, I would like to clarify that I am not advocating complete removal of condoms from all anti-HIV programs. I am instead advocating that condoms be focused on high-risk groups such as truckers and prostitutes. These groups are extremely unlikely to follow abstinence or monogamy, so the best option for them is condoms. For the general population, however, widespread condom distribution has not been shown to be an effective way to fight AIDS because condoms cause risk compensation. Risk compensation describes how, when people feel that they are safer, they take greater risks more often. This effect is the reason why seat belts have been shown to increase driving deaths[1][4]. This effect[2] helps explain why studies have been unable to detect reductions in AIDS prevalence resulting from general condom distribution and education.[3][5] UNAIDS itself has admitted that "Prevention campaigns relying primarily on the use of condoms have not been responsible for turning around any generalized epidemic."[5] The real-world example of Botswana is also telling. From 1993 to 2001, condom sales tripled from 1 million to 3 million, but the prevalence of AIDS among urban women rose from 27% to 45%.[5]

My opponent bases his attack off the supposition that condoms necessarily reduce HIV prevalence. He calls on four sources, but only one of them (#4) is actually about either reducing HIV prevalence in a population or the specific case of Africa. The abstract he gives in #4, however, makes claims which a more recent study[6] directly negates. #4 claims that neither abstinence nor a reduction in sexual partners resulted from abstinence/monogamy education, but my more recent sixth source finds that sexual debut in Uganda has increased and the number of people with multiple partners has decreased. This suggests that abstinence and monogamy education was, in fact, successful in reducing Uganda's AIDS prevalence. (http://www.who.int...)

Although the risk of transmission has an effect on the spread of AIDS, the root cause of its prevalence in some areas of Africa is the cultural habit of having concurrent sexual partners.[7] AIDS is especially contagious a few weeks after it's contracted, so having multiple sexual partners during this time enables multiple rapid infections to occur. Because concurrent partners is the primary reason that Africa has a disproportionately large AIDS epidemic, it only makes sense that programs should focus on reducing concurrency.

Theory and small-scale studies are useful, but the most essential indicator of the success of abstinence and anti-sexual-concurrency programs is large-scale example. Conveniently, such an example exists in the state of Uganda. Unlike its neighbors, who simply distributed condoms and educated people about AIDS, Uganda embarked on a program to promote abstinence, single partners, and, for specific classes such as truckers and prostitutes, condoms.[8] The success of Uganda in reducing AIDS prevalence shows the validity of this approach. Uganda reduced concurrency among women aged 15 and older from 1989s level of 18.4% to only 2.5% in 2000.[9] Unsurprisingly, the AIDS prevalence rate also dropped from 15% to 5%.[5] Uganda has shown that changing behavior has been the best way to fight AIDS. Instead of fighting the symptom – risky sex – that arises from sexual concurrency, we should focus our efforts on reducing sexual concurrency itself. This focus on behaviors change over condom introduction is tied to the most successful AIDS prevalence reduction program seen so far in Africa. As one research paper states, "It is therefore safe to say that what led to this unique drop in HIV prevalence rates in Uganda was change in behavior."[10]

Opponent's sources: Almost all of my opponent's sources were about how effective condoms are at preventing HIV transmission between individual couples, not within populations.

[1] http://hivaids.worldconcern.org...

[2] http://cherylcline.wordpress.com...

[3] http://www.usp.br...

[4] http://www.smithsonianmag.com...

[5] http://www.examiner.com...

[6] www.cwru.edu/med/epidbio/mphp439/Uganda_ABC.pdf

[7] http://www.bluebeetle.me...

[8] http://www.pepfar.gov...

[9] http://www.tnr.com...

[10] www.cwru.edu/med/
Puck

Pro

Note argument 1 has appeared to have been dropped by Con.

"I am not advocating complete removal of condoms from all anti-HIV programs. I am instead advocating that condoms be focused on high-risk groups such as truckers and prostitutes."

Except that the general population in Africa is the high risk category. Unlike say Thailand where prostitution is more normalised and widespread of an industry - the issue of HIV transmission is largest in non sex trade individuals. Especially since you argue they engage in high risk activity (can't have it both ways).

"For the general population, however, widespread condom distribution has not been shown to be an effective way to fight AIDS because condoms cause risk compensation"

Your links only provide at best, dubious contentions for the effect of condom use in Africa. Simply stating a model hypothesis is not nearly evidence for it. Especially when you run the risk of questionable cause fallacies.

Use of condoms are by definition *less* less risky sex behaviour. Errors in individual behaviour comes from either individual misuse or non use of condoms. See R1 where I showed that discordant couples not only don't engage in risk behaviour par course of long term condom use, but that it is specifically condom use that prevents the transmission to the non infected partner.

Likewise attributing HIV rates as a problem *with* condoms is not supported by your links at all. The issue is with education and individual behaviour, not the condoms. Condoms are not 'useless' in general populations - individual behaviour management is the problem. Indeed if we were to discard all objects that could be misused it would make action near impossible. Again, as per R1, condom distribution rarely occurs in a vacuum of information. This fact alone confounds any loose data you have found - not to mention it ignores factors such as discrepancies between condom availability versus population sizes (i.e. your argument presumes a perfect world scenario that is false). Confounds exist for you population % growth of cases too - large numbers of HIV positive births occur for example. Not to mention your source itself ([3]) advocates continued condom usage in the general population.

"Conclusions: Recommendations include more condom promotion for groups at high risk
more rigorous measurement of the impact of condom promotion, and more research on
how best to integrate condom promotion with other prevention strategies."

http://www.kaisernetwork.org...
http://www.unaids.org...

"Because concurrent partners is the primary reason that Africa has a disproportionately large AIDS epidemic, it only makes sense that programs should focus on reducing concurrency."

Such education is already in place and has been since the 80s. Again, risk management programs include condom distribution along side educational programs such as practicing monogamy. Removing condoms simply creates a new variable for transmission that education itself cannot cover - namely transmission reduction during sex (the alternative if we are to take your premises to their full conclusion is advocating a ban on sex from HIV positive individuals and even that presumes foreknowledge of infection).

Con's last argument is about the ABC program in Uganda. As already noted in R1. There is no consistent evidence for abstinence as a factor in the success for the program though it is a facet of the ABC program. His claim of a more recent study is false. The article linked is not an study, it is an at best an essay or review of data (not even a meta analysis). It is either un-submitted or not destined to be submitted for peer review (it's from a graduate online textbook). There reference used within to support abstinence predates my own, making that claim void as well.

Con has ignored the wealth of data against abstinence programs as evidenced in the U.S. and his claim of effectives in Uganda via ABC unfounded (opinion pieces and afore mentioned paper) - it relates to later onset of first sexual activity (also promoted *alongside* condom usage not only in ABC but most other sexual health programs running in Africa). Not, maintaining abstinence as a viable strategy long term strategy - which is supported by data in Africa and as also noted in R1 other regions. Con continues to make the error and thus tries to force the argument, that condom promotion exists in vacuum and thus is attributable to all faults. This is simply not the case at all.

http://www.usaid.gov...

"Almost all of my opponent's sources were about how effective condoms are at preventing HIV transmission between individual couples, not within populations"

Individuals have sex with the population? No. Two people having sex won't spread HIV but it will spread through a population? No.
Debate Round No. 2
Procrastarian

Con

Procrastarian forfeited this round.
Debate Round No. 3
Procrastarian

Con

Procrastarian forfeited this round.
Debate Round No. 4
9 comments have been posted on this debate. Showing 1 through 9 records.
Posted by Freeman 7 years ago
Freeman
Wow... A hardline Catholic
Posted by sherlockmethod 7 years ago
sherlockmethod
Forfeits = 7pts to opponent.
Posted by Puck 7 years ago
Puck
Sure.

The conference transcript was an appendix on one of the mass of articles I flicked through when researching. I'll see if I can find it again; here's the abstract till then.

http://www.aegis.com...
Posted by Procrastarian 7 years ago
Procrastarian
Puck,

Can you please post a link for your fourth source? I've looked up the others and I'm pretty sure I found what you intended, but I haven't been able to access that one. Don't take this the wrong way - I've seen it cited so I know it's real. I just want to read it.

Also, in future rounds, would you mind linking to internet sources you provide? That way I can be sure that what I end up reading is what you intended me to read (i.e. an abstract vs an entire paper vs an article/summary of a paper).

Thanks
Posted by Cherymenthol 7 years ago
Cherymenthol
Good topic.
Great constructives.

+1
Posted by Puck 7 years ago
Puck
Fair enough. :)
Posted by Procrastarian 7 years ago
Procrastarian
I requested a minimum. With you I don't think it will matter. It was only there to deter people who spend five minutes rambling about how they feel instead of reading and evaluating my arguments. You're 59-1, so I don't think you're like that at all. I set the char cap to 5,000 and alluded to the cap so that anyone who accepted would be aware of it since I'm not sure where it shows up. This is my second debate on this site.
Posted by True2GaGa 7 years ago
True2GaGa
lol
Posted by Puck 7 years ago
Puck
Why the requested cap and not the use of limits able to be set?
4 votes have been placed for this debate. Showing 1 through 4 records.
Vote Placed by Procrastarian 7 years ago
Procrastarian
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philosphical
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sherlockmethod
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Korashk
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