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A decision by Muslim clerics in northern Kenya to campaign against the use of condoms has caused alarm among AIDS awareness campaigners who are concerned that abstinence only messages are failing to prevent increasing HIV prevalence rates in Africa.
Earlier this month the clerics held a meeting on Islam and Health in Garissa, capital of Kenya’s northeastern province, an area largely inhabited by ethnic Somalis, in which they agreed to preach against the advocacy of condoms in the fight against AIDS.“A lot of money is being wasted to poison our community ... a huge amount of money is spent on buying condoms, buying immorality,” Sheikh Mohamud Ali, of Garissa district, told the United Nations’ news service IRIN/PlusNews.
Two years ago Kenya’s first lady, Lucy Kibaki, caused outrage among campaigners when she stated: “This gadget called the condom … is causing the spread of AIDS in this country.”
Mrs Kibaki, who chairs the organisation of the 40 African First Ladies, joined with Ugandan first lady, Janet Musevi, in calling for abstinence as the only way to stop the AIDS pandemic in Africa.
Uganda’s claims to have reduced the spread of HIV through abstinence only campaigning, however, have been thrown into doubt with figures showing a 30% rise in AIDS fatalities (BMJ 2008;336:1036; doi:10.1136/bmj.39570.481979.4E).
The clerics decided to actively preach against the use and public promotion of condoms as a strategy to contain the pandemic and prevent pregnancy. They also agreed to oppose the distribution of condoms in villages and educational institutions across the northeast.
“We are not opposed to the Ministry of Health’s campaigns to fight HIV/AIDS, but we are concerned that they are using the wrong way, which is not acceptable to our tradition and religion,” Ali said. “We cannot use the same means to fight these problems all over the country, and we must be involved in the campaigns.”
They said the best way for young people to avoid HIV was through the observance of Islamic teachings such as fasting, regular prayer, and shunning extramarital affairs. They advised men to avoid looking at women, who should dress modestly.
Health workers are concerned that this latest decision will further damage anti-AIDS efforts in the region.
Provincial Medical Officer Dr Osman Warfa, who attended the meeting, said condoms were critical to the fight against the pandemic: “It will certainly give some youths an excuse to avoid the use of condoms, and this will endanger many of them.”
Gill Greer, director general of the International Planned Parenthood Federation, told the BMJ: “The abstinence only approach to HIV prevention was invented by social conservatives in the United States and exported to Africa through the Bush Administration’s HIV prevention programmes. It is a tragedy that at a time when abstinence only has been thoroughly discredited in the United States, some political and religious leaders in Africa continue to stigmatise condom use.
“All the evidence shows that a comprehensive approach to HIV prevention is needed, and a critical part of that is the promotion of condom use. There is no place for ideology or misplaced morality, yet all too often religious and cultural taboos have constrained an effective response to the epidemic.”