Does 'CNN' (Condoms, Needles, Negotiation) Work Better than 'ABC' (Abstinence, Being Faithful and Condom Use) in Attacking the A

This article describes the vulnerability of monogamous women to HIV/AIDS when it comes to the institution of marriage and the presumption that "fidelity" is part of it. Many women believe that marriage shields them from the epidemic and according to the article in Sub-Saharan Africa, as well as many other parts of the world, the majority of newly HIV-positive women are contracting the virus from their husbands. The author, Sinding, contends that improving women's status and negotiating skills is key for HIV/AIDS prevention strategies.

Sinding further suggests that "fifty percent of all married women who contracted the virus in 2002 were infected by their husbands." Based on findings from one study, more than 80% of HIV-positive women were monogamous. He points to statistics from UNAIDS which estimate that five million people were newly infected in 2003 and half of the 40 million people living with HIV/AIDS were women.

The article describes the fact that many women and men feel shame about using condoms within marriage and/or in many cases refuse to use them. The subject matter is described as taboo between partners, and according to Sinding, there is a belief that condom use desensitises the experience of sex.

Sinding makes reference to behaviour change communication efforts and how they may or may not succeed in delaying sexual activity or limiting the number of partners. He points out that "in the absence of any other technology to protect sexually active people from the risk of infection, prevention
messages must stress correct and consistent use of condoms."

According to Sinding, Abstinence, Being Faithful and Condom Use (ABC) is a useful approach that should be accompanied by voluntary counseling and testing,
destigmatisation campaigns, and helping improve the status of women and young girls.

Sinding refers to policies instituted by the United States and the Vatican that support abstinence until marriage. According to Sinding, the Vatican has conducted a global campaign of disinformation about condoms and states that "many in the church hierarchy have denigrated condoms as flawed products." In spite of these policies, according to Sinding, "there is no conclusive proof that abstinence-only programs have been successful in any country in the world in reducing HIV transmission." He suggests that the epidemic must be grounded in science rather than ideology.

Sinding concludes with this thought, "forty years of experience in family planning and reproductive health has shown us that empowering individuals to make
informed choices is the only approach that really works."