Posted by Rocky on August 26, 2003 at 00:13:12
In Reply to: Re: on aids transmission: risk reduction posted by Alan on August 25, 2003 at 18:38:09:
Hi Alan: I read your posts re your own experiences and it was quite amazing and inspiring. Thanks for sharing your story with us.
In regards to HIV/AIDS and sex, it is a given for me that monogomy or refraining from sex are the best ways to avoid STD,s or getting HIV. The problem is that high risk populations generally do not embrace such methods. Many have been raised in environments where prevention / abstinance is never taught or practiced. Does that mean social service workers working with these populations should just abandon them and leave them to their fate? I have worked with high risk populations for many years. I have seen many crash, burn and die through AIDs, other illness, murders, overdoses etc, etc. One of the difficult products of democracy is that citizens have the freedom to make choices. Often these choices negatively affect others in serious ways.
I live in a city that has an infection rate for HIV and other STD's that is high for North America. I feel it is important to make an attempt to work with people, as they are, in hopes they might be able to reduce their risk of harm to self and others. That means bringing a measure of practicality into helping them. People often assume that workers who stress safe sex have no interest in seeing abstinance happen. That is simply not true. In the past, as a streetworker with youth caught up in the sex trade, I taught lifeskills, including safe sex. Safe sex methodology taught correctly always recognizes that in regards to contracting STD's? HIV through sexual contact, only abstinance or a monogomous relationship with a non-infected partner is truly safe. All other methods have various levels of risk attached. The problem is that many sexually active populations are not going to accept such limitations. I do not see working within this reality as a lack of conviction but as a place to start introducing awareness and prevention. When you look into the eyes of an 17 year old who has been exploited in the sex trade since age thirteen who has full blown AIDS and a year to live it becomes evident that all means of intervention are necessary to reduce the numbers of such victims. It is especially painful when they die. Sexuality has been both a curse and a blessing for all of human history. Just look at what happened to the family. I just can't really see what your point is in focusing on the failure rate of condoms. Properly used, which does not always happen, condoms have certain levels of success in preventing the transmission of HIV/STD's. There have been exhaustive studies on why and how condoms generally fail. That does not mean they are the answer. For me they are a means to an end in harm reduction and only one tool in a wide range of approaches to intervention. The caustic environment of the sex trade requires such attempts be made. Safe sex practices being taught in the city I live in has reduced the number of prostitute deaths by AID's , tranference of other STD's to family members by johns and is assisting workers to reach the at-risk community that really needs the help. I would encourage you to try to see the problem from various perspectives. There are no easy answers to dealing with this issue. If there were, people would be impementing them now.
In this regard, the historical persective of how AIDs has been transmitted in Africa is full of complex economic, social and cultural issues.
Sincerely
Rocky