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“Those who complain that ABC is simplistic or reductionistic suggest that we ought to be doing everything to prevent AIDS.

A, B, C, D (for Drugs, or De-stigmatizing AIDS), E (for Equal opportunity)…all the way to Z (for Zero misbehavior?).

I have noticed that some of the proponents of ‘A through Z’ or ‘let’s do everything,’ have trouble accepting the first two letters of ABC; so maybe the real idea is to bury or dilute these in every letter of the alphabet.

…Readers of Global AIDS Link have long known about the ABC approach to AIDS prevention: Abstain, Be faithful, or use a Condom.

Readers also know that Uganda did not invent this; they only implemented the ABC approach in an especially effective way. In the past few months, Uganda’s ABC approach has become the model for AIDS prevention for the Bush administration, at least for the countries where the President’s HIV/AIDS Initiative will be targeted.…

The main thing Uganda did right was to implement a balanced program of the ABCs, and to actually include all 3 elements….

The sexual transmission of HIV can be directly prevented in 3 ways: by avoiding the exposure to risk through sexual abstinence; by reducing the risk of exposure through partner faithfulness and reduction in partners; or by blocking the efficiency of transmission risk through a barrier like a condom. In other words, by practicing A, B or C, the genius of Uganda’s ABC program is that it focuses on what individuals themselves can do to change (or maintain) behavior, and thereby avoid or reduce risk of infection.

…But ABC is far from all that Uganda has done. In fact, the country pioneered approaches towards reducing stigma, bringing discussion of sexual behavior out into the open, involving HIV-infected people in public education, persuading individuals and couples to be tested and counseled, improving the status of women, involving religious organizations, enlisting traditional healers, and much more…

If any country could be said to have promoted “A through Z” to prevent AIDS, it’s Uganda. But Uganda’s message for the public was the simple one of ABC, focusing on factors that, for the most part, are under an individual’s control.

…The only thing simplistic or reductionistic about Uganda’s ABC approach is how some Westerners have interpreted it.

[Dr. Edward Ted Green, AIDSLink, 1Sept03, issue 81, posted 27Aug03 (medical anthropologist, currently senior researcher, Harvard Center for Population/Dev’t Studies; his new book, Rethinking AIDS Prevention, is due in 11/03]