RHReality Check has a series of bloggers from Toronto, looking at HIV prevention through improved access to sexual and reproductive health care. The prevention and treatment of HIV/AIDS is integral to sexual and reproductive health – and yet often ignored in that context.
HIV/AIDS, first and foremost, is a sexually transmitted disease. All too often, however, the response ignores the range of life's issues that relate to human sexuality – and neglects to address this disease for what it primarily is – a sexually transmitted disease.
The pandemic is growing fastest among women and young people, fueled by those who believe that knowing less, rather than more, is a road to informed decision making. They think that telling people to not have sex actually prepares these young people for that time when they first enter the world of sexual activity. The "know nothings" act like there is some particular time when people cross this threshold of human expression, lacking the understanding that there are a variety of factors impacting when someone becomes sexually active.
Talking to young people about their own sexuality does not encourage them to have sex – it prepares them for the time that they will be sexually active. But despite this evidence, opponents – many of them receiving a lot of our tax dollars to run prevention programs – take the simplistic "just say no" approach . This head in the sand attitude is promoting rather than preventing the spread of a deadly sexually transmitted disease.
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Education efforts that help young people understand the physical and emotional aspects of human sexuality, provide tools that empower them to decide if, when and with whom to have sex. They help delay when people have their first sexual encounter – which in itself is a key prevention tool. Abstinence until marriage programs may delay sexual activity, which is a good step, but they often don't actually result in abstinence until marriage – leaving people unprepared for sexual relations once they do start.
President Bush has found ways to restrict access to and cut funding for basic sexual and reproductive health programs. These health care services are the front line in HIV prevention and need to be expanded and strengthened. This is where women who are faithful to their husbands can learn how to protect themselves from HIV, should their partners not be faithful. These programs also diagnose and treat people for other sexually transmitted infections that can otherwise increase risk of HIV transmission.
Human sexuality is complex. It can be difficult for parents who are uncomfortable discussing it with their own children; for individuals sorting through its emotional and physical aspects; and complicated to undertake in a healthful way when the tools to do so are few and far between. Despite their difficulty, each one of those situations is important for sexual and reproductive health. The global leaders and activists meeting in Toronto will shape policies and programs that can more effectively slow this pandemic; together, we can give people the tools to protect themselves.