Abstinence, Evidence, and Analogies
by Rebecca Oas JD, Turtle Bay & Beyond:
In August, I wrote about a comment published in The Lancet arguing that UN resolutions should stop promoting abstinence and fidelity as central components of HIV prevention. The authors of that comment positioned themselves as proponents of evidence over ideology:
“With scientific evidence rather than dogma, countries should adopt and implement a progressive agenda to end AIDS and ensure sexual health and wellbeing for all.”
This trope of science over religious teaching is a frequent feature of arguments that are profoundly ideological in their own right. The sentence above casually refers to the “is” of empirical observation and immediately pivots to the “should” of worldview-infused policy prescriptions.
But policymaking is inherently prescriptive, so we may as well lay our cards on the table: we’re all ideological to some extent, whether that is informed by religion or some other philosophical tradition. (As an aside, there are few people more dogmatic in their pronouncements these days than those who claim to eschew dogma.)
Returning to the debate over abstinence as a feature of UN resolutions, and of public health more broadly, the Lancet recently published some further correspondence related to the original comment. Chika Edward Uzoigwe and Luis Carlos Sanchez Franco responded that while not all abstinence-based programs are equally effective, the effectiveness of abstinence, delay of sexual debut, and reducing the number of sexual partners in HIV prevention is unquestionable.
Uzoigwe and Sanchez Franco draw an analogy to two other important public health concerns: smoking and nutrition:
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