Jim WallisAt an International AIDS Conference in Toronto last August, there were demonstrations supporting men and women who choose to be sex workers, transgenders, and cross dressers. The sexual rights and choices of all people were upheld as sacred—except for one. Anyone who mentioned abstinence was publicly denounced and personally jeered.

So how did the choice to abstain from the leading cause of HIV infections get such a terrible name?

Some of abstinence’s detractors associate it with American foreign policy, currently a very unpopular topic in most international circles. By requiring that one third of HIV/AIDS funds be dedicated to abstinence-based prevention, the U.S. is viewed as pushing a conservative religious agenda upon the peoples of the world. Stephen Lewis, U.N. Envoy for HIV/AIDS in Africa, charges the U.S. with “neocolonialism,” harkening back to a century-old tension between the “puritanical” American missionary view of sex and the perspective of many Africans that sex is simply natural.

And tensions do exist within Africa over the appropriate response to a crisis that has decimated many sub-Saharan countries. While leaders such as Ugandan president Yoweri Museveni have initiated measures to stop the spread of HIV and AIDS with the now famous A-B-C (abstain, be faithful, or use a condom) approach, others have lived in denial or even opposition to efforts to stop the spread of the virus. South African President Thabo Mbeki has obstructed HIV/AIDS education and treatment in his country—where more than 5 million people are HIV infected—and railed against those who he says characterize Africans as sexually promiscuous.

Sex is viewed differently in wealthy Western countries where it is often recreational, consensual, and not primarily intended for procreation. In poor African countries, sex is more often about survival. With a high infant mortality rate, women know that they must give birth to many children in order to raise a few.

And in poor countries where women have few rights, sex is also commoditized, not just as prostitution but also as what is called “survival sex.” Young women learn that in order to eat or pay their school fees, they must befriend an older man. Some such arrangements are made by their own relatives without their knowledge or consent.

So when Americans teach abstinence in that context, it must be a different message than the one used for teenagers in this country, where society and the law protect that choice and an unwanted pregnancy remains a strong deterrent.

In fact, many of the organizations promoting abstinence are not as inflexible as they are portrayed. Their programs often incorporate condoms (not paid for by government funds) and an understanding that only some will embrace the abstinence message. And many who teach abstinence are really teaching about the rights of young women to say no, sometimes a counter-cultural message.

This year’s UNAIDS report documents a delay of first sexual activity in several countries from an average age alarmingly near puberty to one that is closer to a reasonable age of consent. Those who teach abstinence believe the statistics support their message.

Those who criticize abstinence education admit that there is no perfect alternative. “Safe sex” is an oxymoron in countries where as much as one quarter of the population is infected and doesn’t know it, and where condoms are also viewed with suspicion because they stop pregnancies. And women are rarely in a strong enough position to negotiate the use of condoms if they fear their partner—even their husband—is already infected.

But bickering over the best way to help those dealing with HIV/AIDS is not helping anyone. Some of the disagreements are over semantics. Some are over policy.

Some grows out of deep frustration that there is no cure and no obvious way to stop the pandemic that continues to destroy so many lives.

Sincere Christians are on both sides of the debate, but common faith and a shared desire to help those in need offers a way forward. It is time to stop the jeering and stereotyping as well as the moralizing and denigrating and start talking about how we can truly work together to stop the disease that has already claimed nearly 3 million souls this year alone.

Dale Hanson Bourke is author of The Skeptic’s Guide to the Global AIDS Crisis (Authentic, 2006).

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