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Safe sex or healthy sex?


 In the developing countries, the strategy of most HIV/AIDS preventive interventions involve sensitization of individuals to personal risk and social responsibility and encourage behavioral change, including the use of condoms. While condoms are potentially effective, a big difference exists between promoting them in commercial sex work and promoting them for general use. This paper argues that there may be unreasonable reliance on condom promotion in HIV/AIDS prevention programs in developing countries, and in many settings, sex will continue to be unprotected. Further, it may be more effective to put more emphasis on the promotion of genitally healthy sex. Occasional condom use may be worse than no use, in so far as the condom can increase the risk of abrasion to both parties and thus the risk of transmission in subsequent unprotected sex. A related matter is the lack of frankness in much of what is communicated about HIV transmission, as well as the inadequate understanding of sexual behavior among the populace. In view of such, donors and organizations should design scientifically effective interventions to promote genitally healthy sex.
