Wednesday, August 31, 2005

Competing Theories of Folk Psychology

I'm scrolling through the news stories, and see that the blogosphere is totally polarized over this news that somebody at the UN is blaming American fundamentalists for some of the failure to stop the African AIDS epidemic. As MSNBC has it:
The U.S. government's emphasis on abstinence-only programs to prevent AIDS is hobbling Africa's battle against the pandemic by downplaying the role of condoms, a senior U.N. official said on Monday.

Stephen Lewis, the U.N. secretary general's special envoy for HIV/AIDS in Africa, said fundamentalist Christian ideology was driving Washington's AIDS assistance program known as PEPFAR with disastrous results, including condom shortages in Uganda.

The Bush administration favors prevention programs that focus on abstinence rather than condom use and has more than doubled funding for U.S. abstinence-only programs over the past five years.

As part of President Bush's global AIDS plan, the U.S. government has already budgeted about $8 million this year for abstinence-only projects in Uganda, human rights groups say.

Severe shortage of condoms
Activists in both Uganda and the United States say the country is now in the grip of condom shortage so severe that men are using plastic garbage bags in an effort to protect themselves.

"There is no question in my mind that the condom crisis in Uganda is being driven and exacerbated by PEPFAR and by the extreme policies that the administration in the U.S. is now pursuing in the emphasis on abstinence," Lewis told journalists on a teleconference.

"That distortion of the preventive apparatus ... is resulting in great damage and undoubtedly will cause significant numbers of infections which should never have occurred."

Many health experts say condoms are the most effective bulwark against AIDS. U.S. abstinence push may be hurting AIDS fight

I'm not going to comment on the original article, but on the commentary that has broken out over it. There are two distinct views on this topic. One view agrees that American puritans have indeed made it harder to fight the AIDS epidemic, by demanding that Africans abstain from sex rather than practice it safely. The other side feels that it is obvious that abstinence is, in fact, the solution to the problem -- if Africans would just stop having sex, then AIDS would go away.

It's classic.

These are not opposing points of view. Raise your hand if you think that abstaining from sex will prevent the spread of AIDS. Is that everybody? Yes. Everybody agrees that abstinence would be wonderful, as far as AIDS goes.

So both sides agree on that. Now, raise your hand if you think that it is in fact possible that American fundamentalists have influenced policy, and that it is true that the US only supports abstinence programs. Hmmm, again, that looks like everybody.

OK, everybody agrees on the facts.

I think what they don't agree about is a theory of human behavior, what we call "folk psychology."

Theory 1: People are biological creatures, evolved to seek and engage in sexual behavior. They have control over their impulses, but not every single person is going to exercise full lockdown control in every passionate situation.

Theory 2: People are moral beings and must learn to exercise self-control. Those who don't deserve whatever consequences they get.

I hope I have summarized the theories fairly, because I clearly have a favorite, Theory 1. Human beings, like all living things, have a deep drive to reproduce, which nature has cleverly implemented by making sexual behavior very pleasurable. On the other hand, human society is ordered around the idea that we have control over our sexual expression. Marriage, in its many forms, is a feature of every human society on the earth. Those who talk these days about "traditional marriage" are being provincial and self-serving, there are many kinds of marriages, including polygyny, polyandry, arranged monogamy, patrilocal and matrilocal marriages and all kinds of weird variations, and there are numerous other arrangements for sexual contact and sexual behavior permitted by various societies to accommodate the fact that sex is primordial and ubiquitous and enjoyable. It appears to be a basic requirement of any society that it provides some structure for sexual relationships, in order to ensure that the paternity of children is known with some degree of certainty, and that children who are born will be taken care of to adulthood.

Nowhere on the planet earth is there a society that believes that sex can simply be turned off by willpower. The idea is silly, and denies the fact that sex is more profound than any social norm. It is not realistic to think that people can just stop being sexual, and we have seen that every attempt to influence public behavior by blocking sex has resulted in sex finding a loophole, a way to continue, routing around the prohibitions.

Everyone agrees that people have the ability to control their sexual impulses. But it seems to me that some people are in denial about the fact that self-control is not one hundred per cent effective. Even some famous televangelists who preach about abstinence and self-control and the sin of adultery have found themselves on the front pages of the newspapers, begging their flocks for understanding and forgiveness. Self-control is tough, hard work.

The funny thing is that sexual behavior does not require a reason. While some couples have sex in order to become pregnant, sexual intercourse is so attractive, and sexual desires so compelling, that people engage in it whether they desire to reproduce or not. Sometimes the choice of a partner is not well considered -- it is not always a spouse or committed significant other. Sometimes the circumstances are less than ideal, as well, as sex is sometimes a phenomenon of opportunity rather than careful planning. It's not pretty, but it's real.

And so it happens. Those who insist that unmarried Africans should simply stop having sex are living in the same dream world as those who think it should be sufficient simply to tell American teens not to have sex. We need to deal with the reality of human beings, and not try to force the round peg of human nature into the square hole of unattainable self-control.


Anonymous Anonymous said...

Uganda: 'No shortage of condoms'
The Ugandan government has rejected reports by US health campaigners that the country faces a condom shortage.
The US-based Center for Health and Gender Equity said Uganda had been facing a shortage for 10 months.

The organisation said the crisis had been caused by programmes promoting abstinence rather than safer sex.

But a senior official at the ministry of health told a Ugandan newspaper that the country had enough condoms to last until the end of this year.

"We have enough condoms. We just procured 65 million condoms about two months ago and another 80 million is on the way, so there is no shortage of condoms in the country," Mike Mukula told The Monitor newspaper.

"That there is a condom shortage in the country is just a rumour by people who want to spoil the image of this country," Mr Mukula said.

"I challenge anyone who says we do not have condoms to come and I show them our stores," he added.

He said the country uses about five million condoms monthly.

Uganda is often held up as a model of how to fight HIV/Aids, with infection rates falling from 15 to 5%.

But Uganda's anti-Aids campaign has recently been criticised, with some saying that under pressure from the US, it is concentrating on abstinence, rather than all three parts of its Abstinence, Be faithful and Condoms (ABC) strategy.

Story from BBC NEWS:

Published: 2005/08/29 09:30:48 GMT


August 31, 2005 7:38 PM  
Blogger JimK said...

First of all, thankyouthankyouthankyou for replying to the topic of the post, and not undermining the discussion, as we have so often seen here. It is so much nicer if we can present both sides of the issues and then discuss rationally from there. There are some real problems in the world, and it would be good if we could solve some of them, dontcha think?

Now, I recommend you study this summary in Medical News Today. They quote the "no shortage" stuff, and also give the numbers of condoms needed, the numbers imported, the shortfall, and some behind-the-scenes facts that give you some insights into the discussion.

Anyway, as I said, I'm not commenting on the story per se, but am more interested in the discussion and polarization that has followed upon it.


August 31, 2005 8:46 PM  
Anonymous Anonymous said...

JimK said, sexual intercourse is so attractive, and sexual desires so compelling, that people engage in it whether they desire to reproduce or not.

We all know this to be true. Sexual desires can be so attractive and compelling that people engage in sexual behavior regardless of their own circumstances.

Whether the person is single or married, gay or straight, wants to become a parent or is trying to remain celibate, it doesn't matter. You will find some in every category who will engage in sexual behavior.

Yes abstinence is the ideal, but we also know that it is an ideal many people will not maintain perfectly 100% of the time. So we have a choice. We can either hold out vain hope for the ideal to be met every moment of every day by every unmarried person or we can deal with reality which is, if you're going to engage in sexual behavior and you do not intend to become a parent, you should protect yourself and your partner by using condoms.

In the case of my children's health education, I want them to be made aware of the ideal and to strive for it every single day, but I also want them to be prepared for reality.


September 01, 2005 11:28 AM  
Anonymous Anonymous said...

I'd like to add to MCPS Mom's comments. People would still need accurate information about sexuality and reliable forms of birth control even if no one ever had sex outside of marriage. An admonition to abstain from sex until marriage should not replace comprehensive sex ed.

Many codes of moral behavior, both secular and religious, which promote abstinence outside of marriage are silent on sexual practices within marriage. Birth control within marriage is widely accepted. If we're going to teach our kids the skills they need to have solid marriages, we're going to have to keep condoms and other forms of birth control in the classroom.

September 01, 2005 1:26 PM  

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