Kids’ Doc in Jos

I always appreciate receiving links and pointers to interesting articles, and someone recently sent me a copy of “The Fidelity Fallacy: The Link between HIV Infection and Marriage” by Serra Sippel. To oversimplify a bit, the author argues that men will be men, and in some societies marital fidelity is not terribly important, so the American government is wasting a lot of money trying to promote sexual faithfulness as a way to prevent HIV.

In fact, Sippel says, such efforts may be “helping to fuel the spread of AIDS because the approach stigmatizes those who use condoms or those who ask their marriage partners to use condoms.” Her logic here is that couples will be reluctant to use condoms because they are presented as a measure “only to be used if you are sexually immoral.” Hence, she says, we should stop telling people that extramarital sex is immoral, so men won’t feel so bad about using condoms and women won’t feel so bad about asking their partners to use them. Instead of saying that fidelity is more moral than infidelity (which word, by the way, will need a new, positive synonym), we should “associate condom use with masculinity by building on men’s existing sense of responsibility to their families.”

I think that the perspective pushed in this essay is something we need to hear and pay attention to — it’s always important to know how things “really are” and not just how we think they are or should be. We need to be aware that different cultures view marriage in different ways, that infidelity occurs everywhere, and that moralizing can be counter-productive. Yet there are some confusing points in this piece.

First, I don’t understand why Ms. Sippel associates the fidelity issue with morality, while condoms are considered amoral. Not only is fidelity a pragmatic measure and the most effective one (when actually practiced) to prevent HIV, but condoms are, in many cultures, considered a moral issue. So to argue that we should stop moralizing and get practical does not really fit reality too well.

It seems inconsistent to say we should encourage men to use condoms (always, so no one will be stigmatized) in order to be more responsible for their family’s welfare, while de-emphasizing sexual fidelity because it doesn’t fit the culture and since people won’t be faithful anyway. Do condoms fit the culture? Would the author suggest that in deeply Catholic and Muslim countries, we should avoid pressing people to use condoms because their use goes against cultural norms? True, cultural norms have to be considered, but we have to face the fact that many cultural norms in every culture are bad for health. Did we give up on anti-smoking campaigns decades ago when it seemed impossible that we could change such a deeply entrenched habit? Do we now give up on campaigns against obesity and junk food because it’s inevitable that people are going to overeat? Or do we present an ideal and challenge everyone to aspire to it?

Ms. Sippel says, “While it is useful and important to create the conditions necessary for individuals to be able to choose fidelity, the morality of saving lives must take precedence.” Despite this acknowledgment in passing of the value of fidelity (or, as she puts it, “for individuals to be able to choose fidelity,”), the tone of the article as a whole is summed up by its title, “The Fidelity Fallacy.”

I do not have wide experience in US-funded HIV prevention programs. It may in fact be true that moralizing and unrealistic funding restrictions are getting in the way of effective prevention measures. So, I am not trying to detract from the importance of the discussion and analysis of these points. However, I think it is as unhelpful to emphasize “The Fidelity Fallacy” as it is to promote “The Condom Fallacy” from the other side of the ideological spectrum. In our church-based ECWA HIV awareness and prevention program, we stress the importance of sexual abstinence before marriage and fidelity in marriage, and, yes, we even say that fidelity is “moral” (God’s way for us) and that infidelity is immoral (not God’s way, and a destructive path). This article makes me wonder whether we should not, pragmatically, also encourage all couples to use condoms. It’s an interesting question. However, it would be, in my view, irresponsible and a failure of our calling to abandon the quest for a more sexually-pure church and culture.

Yes, let’s recognize that change is difficult, and that sexual fidelity is not an easy answer. Like any discipline, only some will try it, and only some will succeed. Exercise is the challenge for me: I’ve started so many times but rarely persist more than some weeks. Yet, I hope doctors don’t stop encouraging me to exercise simply because I may never achieve a high level of activity.

Serra Sippel, “The Fidelity Fallacy: The Link between HIV Infection and Marriage,” from the Center for American Progress website, http://www.americanprogress.org/issues/2007/08/fidelity.html, accessed Aug 28, 2007.

This entry was posted on Tuesday, August 28th, 2007 at 10:59 pm and is filed under HIV/AIDS. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.