Ugandan leader stresses loving relationships in fighting Aids

The Ugandan leader credited with slashing HIV rates in his country insisted today that abstinence and loving relationships in marriage are crucial to fighting Aids.

Condoms are not the ultimate solution to fighting the disease, said President Yoweri Musaveni’s on the second day of the International Aids Conference in Bangkok.

Condom use has been promoted as a frontline defence in the fight against Aids by countries such as Thailand where a campaign to get sex workers to always use condoms yielded a more than seven-fold reduction in HIV rates in 13 years.

An epidemiologist tracking Asia’s emerging epidemics told conference delegates just ahead of Mr Museveni’s speech that more countries – including China and Bangladesh – face HIV problems largely driven by prostitution, and that promoting condoms is best to block further spread.

Mr Museveni said loving relationships based on trust are crucial in the HIV-fighting campaign, and that “the principle of condoms is not the ultimate solution”.

He told a conference plenary session: “In some cultures sexual intercourse is so elaborate that condoms are a hindrance. Let the condom be used by people who cannot abstain, cannot be faithful, or are estranged.”

Mr Museveni – in a departure from the stance of some of his Western supporters - said the concept of marriage should be flexible, and that sticking with someone when a relationship turns sour opens the possibility that an unfaithful partner brings home an infection.

“Ideological monogamy is also part of the problem,” he said.

Uganda has waged one of the world’s most successful battles against the spread of HIV in a rare success story for sub-Saharan Africa's fight against the illness.

It has enlisted religious groups to help spread information, and pioneered a strategy that later became known as “ABC” or “Abstinence, Being faithful, and Condoms”. Critics have said promoting condoms should be the first priority.

It has brought the infection rate down from more than 30% in the early 1990s to around 6% of the country’s 25 million people last year.

Uganda pledged last month to provide free generic Aids drugs to the 100,000 of the country’s half-million HIV-infected people who have developed full-blown Aids – a major theme of conference delegates who want to better distribute newly-available generic drugs.

Some 25 million of the 38 million infected with HIV worldwide are in sub-Saharan Africa, but the virus is taking root increasingly in Asia, where 7.6 million are infected.

In Asia, the sex trade has been the main engine behind infections in countries such as Thailand and Cambodia, where epidemics exploded by the late 1980s - sparking aggressive responses including campaigns to boost condom use, said epidemiologist Tim Brown.

Other Asian countries where the proportion of men who visit prostitutes is lower will face the same problem – but more slowly, said Mr Brown, a UNAIDS co-ordinator at the Hawaii-based East West Centre.

“The slowly evolving epidemics of Asia are very dangerous, because they will grow steadily and silently,” Mr Brown said, and are less likely to prompt aggressive government responses.