[Random-bits] Randy Tobias, risky sexual behavior, and AIDS

[James Packard Love]

http://www.huffingtonpost.com/james-love/randy-tobias-risky- 
sexua_b_47160.html

The Huffington Post: Randy Tobias, risky sexual behavior, and AIDS
April 28, 2007
James Love 	

The news that Randall Tobias, the former Lilly executive and chief of  
the Bush Administration's global AIDS programs, was using the  
services of call girls, led to this reaction from one AIDS activist:

     Oh my God. Mr. Married Abstinence only used an ESCORT  
service!!!!!! The anti-prostitution pledge promoter?

The press coverage about this has predictably focused on the apparent  
hypocrisy of the leader of a government agency that to fight AIDS in  
Africa and other developing countries, promotes "abstinence only" and  
derides sex workers, and then is caught doing exactly the opposite.

AIDS is a terrible health crisis, and no one would deny the  
importance of discouraging risky sexual behavior, particularly in  
countries and populations with extremely high infection rates. The  
problem with the Bush Administration's "abstinence only" efforts was  
the word, "only," since prevention should include other strategies,  
including the use of condoms.

I asked friends who would know, "How much of the 'abstinence only'  
efforts at USAID were the fault of Tobias, and how much from the  
White House." The push for this policy, which is actually mandated by  
a Congressional requirement, came from Republicans in Congress, the  
White House and the religious right.

Activists give Tobias much more blame for efforts to protect big drug  
companies from competition from generic manufacturers of AIDS drugs,  
for example, by undermining the World Health Organization's program  
to certify generic AIDS drugs (the WHO pre-qualification program) and  
forcing U.S. taxpayers to unnecessarily pay top dollar for brand name  
AIDS drugs in PEPFAR treatment efforts. This policy has been poorly  
covered in the press, but it is far more consequential than Tobias'  
sex habits.

That said, the Tobias case illustrates just how difficult it is to  
persuade people to give up risky sexual behavior. This, and plenty of  
other evidence leads many experts to believe that the "abstinence  
only" programs pushed by the Bush Administration are costly wasted  
opportunities to reduce the harm of AIDS.

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James Packard Love
Knowledge Ecology International
http://www.keionline.org
james.love@keionline.org
Washington, DC +1.202.332.2670

"If everyone thinks the same: No one thinks." Bill Walton"