Thought Theater

WHO Updates AIDS Model - Guess Who Attaches Moral Judgement? genre: Gaylingual & Hip-Gnosis & Little Red Ribbon-Hood & Uncivil Unions

The inclination to view natural disasters and disease as signs of God's wrath remains a frightening demonstration of the dangers of religious dogma. Time and again, a vocal group of religious leaders attribute these tragedies to the morality of those affected.

One long standing example is HIV/AIDS, though there are many more. When HIV first appeared, there were numerous religious leaders and politicians who chose to characterize the disease as punishment for homosexuality. Since the beginning, the fact that the infection rate in lesbians was a fraction of that found in gay men seemed to defy the efforts to apply a moral judgment. Regardless, the prevalence of these prejudices continues to exist.

The release of a new report by the World Health Organization, in which the organization acknowledges that HIV isn't likely to become a heterosexual pandemic, has already triggered a new round of moral pronouncements. I'll discuss the invective offered by the Family Research Council beneath the following excerpts. They are from an article in The Independent which details the reports conclusions.

A quarter of a century after the outbreak of Aids, the World Health Organisation (WHO) has accepted that the threat of a global heterosexual pandemic has disappeared.

In the first official admission that the universal prevention strategy promoted by the major Aids organisations may have been misdirected, Kevin de Cock, the head of the WHO's department of HIV/Aids said there will be no generalised epidemic of Aids in the heterosexual population outside Africa.

Dr De Cock, an epidemiologist who has spent much of his career leading the battle against the disease, said understanding of the threat posed by the virus had changed. Whereas once it was seen as a risk to populations everywhere, it was now recognised that, outside sub-Saharan Africa, it was confined to high-risk groups including men who have sex with men, injecting drug users, and sex workers and their clients.

[...] But we have to be careful. As an epidemiologist it is better to describe what we can measure. There could be small outbreaks in some areas."

Aids organisations, including the WHO, UN Aids and the Global Fund, have come under attack for inflating estimates of the number of people infected, diverting funds from other health needs such as malaria, spending it on the wrong measures such as abstinence programmes rather than condoms, and failing to build up health systems.

Dr De Cock labelled these the "four malignant arguments" undermining support for the global campaign against Aids, which still faced formidable challenges, despite the receding threat of a generalised epidemic beyond Africa.

Any revision of the threat was liable to be seized on by those who rejected HIV as the cause of the disease, or who used the disease as a weapon to stigmatise high risk groups, he said.

The biggest puzzle was what had caused heterosexual spread of the disease in sub-Saharan Africa - with infection rates exceeding 40 per cent of adults in Swaziland, the worst-affected country - but nowhere else.

"It is the question we are asked most often - why is the situation so bad in sub-Saharan Africa? It is a combination of factors - more commercial sex workers, more ulcerative sexually transmitted diseases, a young population and concurrent sexual partnerships."

The inclination to assail the motivation of WHO may have some measure of merit...but the criticism is primarily a demonstration of all that is wrong with a reliance on hindsight. The truth of the matter is that we knew nothing about HIV when it first appeared which lent credence to the alarm that was disseminated. Frankly, any cynical calculation on the part of WHO (based upon the value judgments that accompanied the discovery of the virus) are understandable and, in my opinion, justifiable. Truth be told, the U.S. government drug its feet in addressing the epidemic...despite the evidence. I think it's fair to conclude that some of that hesitation centered on the fact that gays were the predominant demographic.

In order to understand the motivations that may have led to some of the alarm generated by WHO and other organizations on the forefront of the epidemic, all we need to do is take a look at the Family Research Council's reaction to this new report.

25 years after the beginning of the AIDS epidemic, the leader of the World Health Organization's efforts against the disease has finally admitted the obvious--there will be no worldwide AIDS pandemic among the general heterosexual population.

In the article, however, one line stood out in particular:

"Any revision of the threat was liable to be seized on by those who rejected HIV as the cause of the disease, or who used the disease as a weapon to stigmatise high risk groups, he said."

In other words: We couldn't tell the truth, because it might have made people think there is something wrong with homosexuality, prostitution, and drug use.

Duh! Thank you FRC for confirming the legitimacy of the fears held by the World Health Organization. Aside from the obvious moral judgment, the position taken by religious groups like the FRC ignores a number of relevant considerations. First, if morality is the underlying concern...meaning HIV evidences immoral activities...then we should look at all sexual activity; not just the activity that can lead to HIV. Here's the point. It's easy to scapegoat gays, drug users, and prostitutes...but doing so ignores other available data...and therefore the moral judgments that could be applied because of it if one were so inclined.

I've long argued that the best way to understand how inappropriate it is to selectively judge the morality of the above groups is to look at the rates of sexually transmitted disease in the heterosexual population. In truth, the emergence of HIV received an inordinate share of attention (rightly so) because it was a fatal disease. At the same time, were any of the many STD's commonly found in heterosexuals to have suddenly mutated into a similarly fatal infectious disease, the number of deaths would likely overshadow those found in the early stages of the HIV epidemic.

Hence, if unacceptable sexual relations (multiple partners, adultery, premarital sex, etc) are the grounds for judging gays, drug users, and prostitutes to be immoral, the same judgment should be applied to the millions of heterosexuals who have contracted an STD.

So why is the lion's share of the negative judgment reserved for gays, drug users, and prostitutes? Well, the easy answer is because the religious heterosexuals leveling the charges prefer to focus on the actions of others rather than address their own predisposition for impropriety. Besides, the vast majority of heterosexually transmitted diseases can be discretely (and quickly) addressed by one's physician or at any number of clinics that offer a degree of discretion and/or anonymity.

Thankfully, with many of these pillars of piety, their dalliances eventually betray their efforts to hoard the high ground. Regardless, they continue to insist upon directing their derision towards those groups they choose to vilify. I do find it rather amusing that they've chosen to include prostitution on their list of uber-sinners. After all, who do they think heads the list of "sinners" who make it possible for prostitution to flourish? It isn't homosexuals and I think we pretty much know where drug users are spending their cash.

I want to address one additional area of hypocrisy that frequently goes unnoticed. Under the Bush administration, faith based groups have been enlisted in the efforts to combat HIV in Africa. The preferred model for many of these groups is to encourage abstinence over comprehensive sex education that would feature the use of condoms. The working assumption for many of these groups is that promiscuity is largely responsible for the crisis that exists in Africa.

However, you'll note in the WHO report that they identify a distinction with regard to the cultural sexual practices found in some regions of Africa. That distinction is identified as "concurrent sexual partnerships". My interpretation of this phenomenon is that it's not unusual for some Africans to be simultaneously involved in multiple relationships that include sexual contact. This doesn't mean that these Africans have more total sexual partners than the average American; it simply means that they approach the occurrence of multiple sexual encounters differently than one would expect to find in the United States.

I would describe the African structure as a form of polygamous interaction versus the American model of serial monogamy...or ongoing bouts of adultery. Based upon these two models, the passage of the HIV virus is apt to occur with more frequency and consistency in African society because of an ongoing pool (a linked web if you will) of repetitive sexual partners. Once one member of the pool is infected, all are apt to be infected over time. The fact that the American model would more likely involve one extramarital partner at a time makes the passage of an STD less of a certainty given the absence of an extended pool of simultaneously ongoing sexual partners.

The point I'm making is that many of those who are inclined to apply a moral judgment to those infected with HIV are prone to ignoring their own morality. They're able to do so for three primary reasons. One, it's rare for any of the common heterosexual STD's to result in death so they can be kept under the radar. Two, not all of these STD's are chronic infections so treatment resolves the infection and puts an end to ongoing transmission. Three, the manner in which Americans engage in multiple sex partnerships masks the number and frequency of such encounters and may minimize the potential for predictive infection patterns.

At the same time, none of these explanations can serve to remove any of the same moral considerations and/or judgments that are being routinely applied to those with HIV. While I've provided a justification for an equitable distribution of judgment, I am not making the case to enact it. Instead, I find the assertion of morality as an explanation for natural disasters or diseases that result in death to be abhorrent. Given that death is inevitable, attempts to attach moral attributions to the causation of death opens the door to doing so with all deaths (of course I'm excluding reasonable judgments made, and punishment applied, relative to murder or an identifiably criminal act). Further, such assertions simply can't be substantiated.

Aside from an absolute disregard for the random nature of our existence...inclusive of death and disease...the presumption that we mortals could anticipate and apply the all knowing conclusions of an immortal deity is arrogance of the highest order.