Pubdate: Sat, 19 Aug 2006 Source: Ottawa Citizen (CN ON) Page: a05 Copyright: 2006 The Ottawa Citizen Contact: http://www.canada.com/ottawa/ottawacitizen/ Details: http://www.mapinc.org/media/326 Author: Tom Blackwell, National Post Alert: Save Lives by Preserving InSite http://www.mapinc.org/alert/0334.html Cited: 16th International AIDS Conference http://www.aids2006.org Bookmark: http://www.mapinc.org/hr.htm (Harm Reduction) HARM REDUCTION WINS, ABSTINENCE LOSES It's A Scientific Fact, Biologist Declares TORONTO - About midway through the International AIDS Conference, Dr. Mark Wainberg, the bookish-looking AIDS scientist from Montreal and meeting co-chair, found himself in the thick of a chanting demonstration of prostitutes. As the sex workers and their supporters, including a statuesque transvestite, shouted out for legalization, Dr. Wainberg shouted along. As they punched the air in defiance, the dark-suited microbiologist punched too. At this massive and extraordinary conference, supporting such causes is almost compulsory, as is speaking out for the rights of injection-drug addicts, lamenting the plight of the overlooked transsexual community and tolerating promiscuity, so long as that multiple-partner sex involves condoms. Abstinence is a dirty word and human rights take precedence over quarantine. To some, it might seem like political correctness run amok. But as the largest-ever AIDS conference ended yesterday, researchers and agency leaders said the science is irrefutable that judgmental approaches to the groups most at risk of getting HIV do not work. Trying non-coercively to change that behaviour or make it less likely to spread HIV -- known as harm reduction -- is the best hope, they say. "Yes, a number of people can get emotional about the issues -- but the fact is that it ought to be scientific agendas that drive what we do," Dr. Wainberg said in an interview. "And it's as simple as this: harm reduction works -- that is established medicine -- abstinence does not work and people lie about their sexuality and their sexual behaviour all the time. Anyone who would articulate that being faithful is the solution to this problem is clearly putting their head in the sand." Only by reaching out to "marginalized" and, in some case,s criminal groups like drug addicts and prostitutes, can public health hope to communicate ways to make their behaviour safer, scientists stressed at the forum. That largely meant, though, that the role of personal responsibility in avoiding infection, at a time when gay men in North America, for instance, are increasingly neglecting safe-sex methods, was largely overlooked. Still, some aspects of the liberal approach were challenged at the meeting, which drew 17,000 delegates and 2,300 media people from around the world. A few public-health leaders called for more aggressive HIV screening systems, which some human rights activists oppose. And in a closing news conference, the acting head of the World Health Organization said the conference did not deal enough with personal behaviour and condom use. "We have one magic bullet that works," said Dr. Anders Nordstrom, holding aloft a condom, after colleagues suggested there is no one method that can always prevent HIV infection through sex. Said Dr. Kevin DeKock, the UN agency's head of infectious disease: "The WHO believes in a rights-based approach but as the epidemic has changed -- keeping on doing the standard approaches that we always have used is reactionary. We need to evolve. Evolve or die." Scientists also voiced guarded hope about a range of experimental drug technologies -- and old-fashioned male circumcision -- that could eventually prevent many HIV infections biologically or chemically. - --- MAP posted-by: Richard Lake