Aids, Condoms and Africa

Regarding my post, The African Cliff, a number of readers wrote to me about the Catholic Church's anti-condom teachings (and apparently in some cases mis/disinformation campaigns).

I have three reasons for thinking that Catholic teaching on condoms, whatever you might think of the substantive issue, is not a major factor in the African Aids crisis.  First, Catholics in the US don't seem to find it difficult to ignore the Church's teachings when these are costly.  Second, many African countries with high Aids rates have few Catholics.  (Compare the countries in yesterday's graph with this map of Catholic membership in Africa.)  Third, couples who do not use condoms but follow Catholic teaching in regards to monogamous marriage are unlikely to contribute much to the Aids problem.  It seems inconsistent, moreover, to assume that religion is strong enough to prevent men from using condoms but not strong enough to stop them from sleeping with multiple partners.  Does the man having sex with a prostitute feel less guilty because he isn't wearing a condom?  (Admittedly, I don't know enough about venial versus mortal sins to be sure about the latter.)

We hope that Marginal Revolution can be enjoyed by the whole family so I am somewhat reluctant to discuss a second hypothesis brought to my attention by Steve Sailor.  Nevertheless intellectual honesty compels me to mention dry sex.

Epidemiologists are also finding that multiple concurrent sex partners are an important transmission route.  Halperin and Epstein writing in the Lancet (subs. required) note:

Of increasing interest to epidemiologists is the observation that in Africa men and women often have more than one—typically two or perhaps three—concurrent partnerships that can overlap for months or years.  This pattern differs from that of the serial monogamy more common in the west, or the one-off casual and commercial sexual encounters that occur everywhere.

Morris and Kretzschmar used mathematical modeling to compare the spread of HIV in two populations, one in which serial monogamy was the norm and one in which long-term concurrency was common. Although the total number of sexual relationships was similar in both populations, HIV transmission was much more rapid with long-term concurrency—and the resulting epidemic was ten times greater.

It is important to understand that multiple concurrent partners does not mean more partners in a lifetime.  What differs in parts of sub-Saharan Africa is the pattern and timing of sexual relations not the number of lifetime partners.  (See also Sailor for a tendentious but interesting take on the why the pattern might be different in parts of Africa.)