> �Robert Carnegie <
rja.carne...@excite.com> wrote:
>
> > A cardinal? �I said bishops.
>
> > When a bishop speaks you're supposed to listen, I bet.
>
> > I think I also read one version that said several
> > Vatican science laboratories had repeatedly proved
> > this about condoms.
>
> > But I don't care very much about it.
>
> And the work has not been replicated outside the Vatican? And secular
> Calvinist and Lutheran scientists get different results? One gets very
> suspicious about such results. Maybe someone sticks a pin up the
> Vatican condom machine.
>
> --
as so often, the story is slightly more complicated. I assume that the
reference is to the document produced by Cardinal (not bishop)
Trujilo. That one did not cite or carry out any independent research
on condoms, and to the best of my knowledge the vatican never has.
Rather, it takes data from (quite reputable and as far as I can make
out sound) studies and then uses them for a highlight problematic risk
assessment model.
If I recall this correctly, the studies cite failure rates in condoms
for STD prevention from 0-15%. The range might be due to them
measuring different things, in particular, the difference between
laboratory testing of newly minted condoms, and testing them in real
life settings (say a street prostitute in Africa leaving them exposed
to the sun for extended periods of time). That would of course be the
first problem if you then use these figures for risk assessment, as
you'd have to factor in how much you can reduce these problems through
education etc., one of the flaws of the report.
OK, next step is even more problematic: based again on perfectly
secular and mainly sound studies, he points to some countries where
despite the increase in condom use, AIDS did not just not decline, but
increase. Bit of cherry picking data here, as there are also well
documented success stories, Europe, the US and parts of Asia in
particular.
On this basis, an explanation is offered that is based on another well
documented phenomenon, risk compensation (aka Peltzman effect) That
effect explains why units issued with body armour in an armed conflict
often saw an increase in mortality - not just because the armour
slowed them down, and most certainly not because it did not work in
theory, but because they were now taking higher risks, and these were
actually greater than the protection (which never is perfect) offered.
So Trujilo argues that in those cases where we found an increase in
AIDS coinciding with one in greater condom use, risk compensation
meant that the small percentage of faulty condoms increased the
overall rate. Again, problematic for all sorts of reasons (e.g. by not
looking for confounding factors which could indicate that the causal
arrow is the other way round - an increase in prostitution caused
agencies to start distributing condoms, just not enough.
So no "miracle physics", just different risk models, and what you
could accuse the vatican of is to talk up a real, but statistically
small risk, leaving people exposed to much greater risks instead.
Having said that. it also had the effect that epidemiologists looked
a bit harder at the data, mainly to refute the idea, and some have
come to a "well, actually..." conclusion. Ed Green is of course
a ...controversial... figure, but I don't think you can accuse him of
religious motivations, and his research at Harvard and later John
Hopkins was peer reviewed etc His line is much more nuanced - it
depends a lot on other social and cultural factors if condoms decrease
AIDS or don;t have an effect (and under very specific conditions can
increase it) If you have good distribution and quality control systems
and educated users (Europe, US), and/or when the spread is mainly
through prostitution, and you can enforce a close to 100% use
(Cambodia, Thailand) the beneficial effects are massive. If on the
other and spread is mainly along "stable affairs", where most people
have several, but stable partners, usage declines due to the mutual
(misplaced) trust, and can then even be harmful (when man start in
addition to see prostitutes, and think they are perfectly safe f they
use a condom.
This all of course assumes that the vatican report should be read as
a risk management document. If you don't, things get even more
complicated and also a bit paradoxical,both for the vatican and its
detractors.