To Abstain or Not to Abstain? Reflections on AIDS-Prevention
As part of my work I’ve been doing some research into HIV/AIDS in Southern Sudan. From what I’ve found so far it looks like prevalence rates in South Sudan are relatively low compared with neighbouring countries, but are steadily rising as refugees and displaced persons return home in the wake of the peace agreement. Because of the projected increase and because of the debilitating effects AIDS can have on a community (AIDS often hits people at the age they are most productive to their families, economies, and communities), governments and international organizations are prioritizing the issue. This is something most can agree upon.
What has been a point of contention is how to deal with the epidemic. One of many examples of AIDS-related controversy is former American President Bush’s “President’s Emergency Plan for AIDS Relief” (PEPFAR) which was subject to much praise because of its scale and size, but received a lot of criticism because of its abstinence-only approach to prevention. Apparently, the consensus among the overwhelming majority of those in the field of AIDS prevention agree that abstinence-only approaches don’t work and that the best course of action is a combination of promoting abstinence and safe sex.
It got me thinking, as a Muslim, the choice between promoting abstinence or safe sex seems like an obvious one. I can safely say that most Muslims would feel great discomfort with, for example, condom distribution. In fact, it is the argument of a great number of faith-based groups (especially conservative Christian groups in the West) that promotion of condom use is in itself a promotion of increased sexual promiscuity – which would lead to more STDs, not less. But one cannot ignore the counter-argument that when casual sex is so pervasive in a society, preaching abstinence may often fall on deaf ears.
Personally, when I heard of a program that was attempting to prevent AIDS by preaching abstinence in American high schools, my first thought was it doesn’t make much sense to tell a group of American teenagers to abstain from sex out of fear of contracting AIDS. This strikes me as ineffective simply because teenagers in general are not yet at an age where their brains are fully capable of comprehending the consequences of their actions, plus, peer pressure to have sex is so strong in that environment. Add to that the fact that pre-marital sex is such a normalized thing in Western culture in general, preaching abstinence out of fear of contracting AIDS seems tantamount with telling a child not to eat candy because they will get cavities.
I have been struggling to form an opinion on this issue, probably because I don’t have enough knowledge of Islamic law. But what I am beginning to believe more and more is that this is not an issue with a one-size-fits-all solution. What would work in an environment where pre-marital sex is still stigmatized and viewed as wrong (even if practiced underground) might be different from what would work in an environment where it is viewed as normal and acceptable. It doesn’t make sense to use the same prevention-strategy in such drastically different cultures. I am not saying in this post what strategy I do or do not support. But what I’m saying is that while I would feel silly going to an Egyptian high school and giving them a lecture about proper condom use, I would feel equally as silly going to a high school in the West and lecturing them on abstinence.
I am a big believer in inherent capacity of Islamic law to adapt to different cultures and social environments. It is, in my humble opinion, one of the strongest features of Islam that makes it a way of life rather than just a religion confined to the spiritual sphere. On the other hand, Prophet Muhammad (peace be upon him) was very firm when it came to forbidding pre-marital sex, which was extremely pervasive in Arab culture at the time. And while alcohol – an equally pervasive part of Arab culture at the time – was banned gradually, pre-marital sex was banned outright. There must be a reason for the different approaches used.
I often reflect on this and wonder, is my unease with preaching abstinence in certain cultures due to a weakness in my iman, or is there perhaps, some religious basis to this feeling? I hope, insha’Allah, to ask an Islamic scholar (one who has lived in the West) about this issue.