Innocent Mistake or Academic FraudIn the paper "Condom Promotion for AIDS Prevention in the Developing World: Is it Working?" by Norman Hearst, MD, MPH1 and Sanny Chen, MHS1,2, the authors use footnotes fraudulently in an attemp to prove their points. This paper is available from the pro-abstinence Medical Institute for Sexual Health, in a pdf called "Evidence Monograph." First, a little background. Human Rights Watch has this report which is pretty useful. Basically, in 1987, Uganda began what it calls the ABC program for fighting HIV/AIDS, then ravaging the country. This included, but was not limited to, education of primary and secondary school children about HIV/AIDS, condoms, and the value of being abstinent before marriage and faithful after marriage. Uganda is often considered a success story, which, it turns out, is part of the problem. For Christian leaders, like President GW Bush, want to credit abstinence and faithfulness, and others want to credit condoms. Apparently, some groups are getting rich off condom distribution. Others want condoms stopped, because it violates their ethical or religious sentiments. Let's look at this one paragraph of the "Condom Promotion" paper by Hearst and Chen.
Condoms were not central to the initial (ie, pre-donor) response to the AIDS epidemic in Uganda. Messages focused on delaying sexual debut, abstinence, being faithful to a single partner (called "zero grazing"), and condoms, roughly in that order.Powerful facts, if they happened to be true. Let's look at the footnotes cited.
41,48Large- scale condom social marketing did not begin until the arrival of the foreign donors in the mid-1990s. 54In fact, as late as 1995, only 6% of Ugandan women and 16% of Ugandan men had ever used a condom, with consistent use being much lower. 48Although Ugandans now use more condoms, particularly with casual partners, these recent condom use rates cannot be credited for what happened earlier. 51
- 41: Joint United Nations Programme on HIV/AIDS (UNAIDS). Thailand Epidemiological Fact Sheets on HIV/AIDS and Sexually Transmitted Infections (2002 Update). Geneva: UNAIDS; 2002. Link (pdf)
- 48: Kilmarx PH, Palanuvej T, Limpakarnjanarat K, Chitvarakorn A, St. Louis ME, Mastro TD. Seroprevalence of HIV among female sex workers in Bangkok: evidence of ongoing infection risk after the "100% condom program" was implemented. Journal Acquired Immune Deficiency Syndrome 1999; 21(4):313-316. Link(abstract)
- 51: Stoneburner R, Carballo M, Bernstein R, Saidel T. Simulation of HIV incidence dynamics in the Rakai population-based cohort, Uganda. AIDS 1998; 12(2):226-228. Link(pay subscribers only)
- 54: Deloitte Touche Tohmatsu. Commercial market strategies, Uganda report; 2001 Link(pdf)
CORRECTION: The Evidence Monograph containing this paper also contains a paper by Dr. Green of the Presidential Advisory Council on HIV/AIDS. I didn't notice the pdf contained two papers, and originally, mistakenly, connected Dr. Green with the fraudulent footnotes.