Tuesday, March 26, 2013

Culture, Not Better Condom, the Real Answer

Bill Gates is offering $1 million to the inventor that can build a better condom. From the FNN story:
Wesley Smith
Philanthropist and Microsoft founder Bill Gates is offering start-up funds of $100,000 to anyone who can come up with the “next-generation condom,” according to Grand Challenges in Global Health. The Round 11 of Grand Challenges Explorations initiative through the Bill and Melinda Gates Foundation is aimed at improving the lives of the world’s poorest people – and a new, innovative condom could do just that. The condom must be effective at lowering the chance of transmitting sexually transmitted diseases, and offer incentive for men and women to use it.
If chosen, the Foundation would continue to fund the condom up to $1 million. “To overcome persistent health and development problems, we need new, game-changing ideas,” Chris Wilson, director of Global Health Discovery & Translational Science at the Foundation, said in a press release. “Inspiration can come from anywhere, and we are hopeful that this new round of Grand Challenges Explorations will uncover innovative approaches to improve lives around the world.” According to the press release, the new condom will “preserve or enhance the pleasure so as to increase uptake and also promote its regular use.”
I still believe that relying on the condom as the primary diseases inhibitor works at cross purposes with the goal of better public health outcomes. It is like telling people they really don’t have to stop smoking, just use a filter or a water pipe to reduce disease.
If we want to spread the devastating HIV and STD epidemics, telling people that they can have an exuberant sex life and safety too seems less wise than trying to create a sense of sexual restraint and probity as both the cool and responsible approach. But issuing a clarion call for self control is disfavored because the international community disdains moralism and sees open sexuality as a liberty right. And yet, the ABC approach (abstinence, be monogamous, use condoms.) worked very well in Uganda–at least until they backed off from the A and B.
If you build a better condom will they beat a path to your door? I doubt it. The problem is that pushing enhanced sexual sensation in a condom also pushes more sex, and the only reliable answer to lowered rates of infection is less sex other than with an uninfected mutually monogamous partner.
But then, I am an old guy who believes that we have the capacity to control our hormones, if not because it is “right,” at least because it is best for our health.

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