Mounting evidence in support
of harm reduction strategies has not translated to the government support
needed in many countries to endorse the widespread adoption of proven
HIV and STD prevention tools such as comprehensive sexual education
programs, syringe exchange, and substitution therapy. In the session
"Research-Based Public Policy: Why is it not the Golden Standard?"
a diverse panel discussed the data on harm reduction and why many policymakers
refuse to be swayed by it.
In his extensive reviews of
sexual education programs targeted at young people between the ages
of 19 and 25, Douglas Kirby, PhD, has produced convincing evidence that
comprehensive sexual education programs are more effective at positively
influencing the sexual behaviors of young people. Of the eight evaluations
conducted of abstinence-only programs, only one was found to delay initiation
of sexual activity. However, in 32 evaluations of comprehensive sexual
education programs, 15 programs were effective at delaying sexual initiation.
Dr. Kirby has presented his findings to some federal policymakers in
the U.S. whose response is that the sexual education of young people
should be driven by morals, not evidence.
Maybe their response should
not be so surprising. According to Gerry Stinson, executive director
of the International Harm Reduction Association, policies are driven
by many factors, including politics, funders, ideals, values, theories
on human behaviors – but, in most cases, not evidence. As Stinson
shared, "evidence is important, but only one small component of effective
Nandee Bandyopadhyay, an advocate
for sex workers in India, agrees and questions whether the goals of
public policy are for the public good as policies are created to appease
competing constituent groups. Bandyopdhyay recommends defining "rights"
rather than talking about what is right – using activism not just
advocacy — along with incorporating evidence into advocacy messages.
Unfortunately, the data does not speak for itself.