D. Murali

Chennai: Thailand has taught us that fewer men buying sex translates into lower risks for HIV infection, writes Elizabeth Pisani in ‘The Wisdom of Whores: Bureaucrats, brothels, and the business of AIDS’ (www.landmarkonthenet.com).

The country has also taught us that it is easier to get condom use up than keeping the sex industry down, the author adds. “The proportion of men buying sex halved over four years in Thailand. The proportion not using condoms when buying sex halved in just a year and a half. As condom factories get busier, the workload in the VD clinics falls.”

Where condoms have been promoted without let or hindrance, they tend to get used, especially in the riskiest encounters, observes Pisani. “In Thailand and Cambodia, in Vietnam and China, in Nepal and the south Indian state of Tamil Nadu, in Brazil and Australia, in the Netherlands and Britain, condom use in commercial sex is the norm, and condoms are very frequently used in casual partnerships too.”

A study in contrast is Africa, where HIV prevention failed initially because most countries didn’t try very hard, the author frets. “As late as 1999, when 23.3 million Africans were estimated to be HIV-infected, foreign agencies provided Africa with 500 million condoms. That’s just over three condoms per year for each man aged 15-49.” Quite bizarrely, if you were to add the number of all condoms that African governments paid for, “it takes it up to a grand total of 4.6 condoms per man, enough to have protected sex once every three months.”

We could damp down HIV across vast swathes of the globe just by being honest about who is infected and why, and by giving them the information and services they need to interrupt transmission, assures Pisani. “And we could probably do it for less money than we already have for prevention.”