A genuinely novel but possibly doomed to failure idea for reducing the spread of HIV. It’s a good idea, an inexpensive one, one that’s worth trying, and one which could have astonishingly few side effects even if it didn’t work at all.

Unfortunately for the idea to be successful societies around the world would have to hop over an awful lot of cultural assumptions, social stereotypes, and hot-button vocabulary terms. It’s a wonderful idea that’s as likely to trigger “sex positive” progressives, “sex negative” social conservatives, free thinkers and the religious. Curious yet?

Oh, and it would only take a month.

Now are you curious?

The idea depends on three things epidemiologists have known since some time in the 1980s:

• For such widespread disease HIV is actually surprisingly difficult to transmit sexually once it’s established in the body.
• HIV is most contagious — 100 to 1000 times as infectious! — in the first month after infection.

• HIV’s rate of new infection hovers at such a low level that even a very small drop in transmission could push it past its sustainability threshold and into decline!

So here’s the pitch as reported by Alex Duval Smith in The Guardian. Read it and see what if any cultural speed bumps bring you up short.

Leading scientists fighting the world’s worst Aids epidemic have called on African leaders to head a month-long sexual abstinence campaign, saying it would substantially reduce new infections.

Epidemiologists Alan Whiteside and Justin Parkhurst cite evidence that a newly infected person is most likely to transmit HIV in the month after being exposed to it. An abstinence campaign could cut new infections by up to 45%, they say – a huge step in countries such as South Africa, Zimbabwe, and Swaziland.

...

Whiteside’s research with Parkhurst, of the London School of Hygiene and Tropical Medicine, focused on religious groups, such as Muslims who abstain from sex during Ramadan, and Zimbabwe’s Marange Apostolic sect, which bans sex during Passover.

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Whiteside said a month-long pledge to use a condom could also be effective. “The main thing is to agree on a bounded period in which the entire population would live by the same rule,” he said.

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Whiteside insists that a month-long campaign in his country, South Africa, is realistic. “We have this idea that we are going to put everyone on treatment. That is actually pretty fanciful. A month of abstinence or condom use is far less difficult to achieve.”

Read the quote in context here.

Cool huh? I mean seriously cool. HIV incidence is low among people who observe Ramadan and Lent compared to, well, comparable people who don’t. Ramadan and Lent both last a month. HIV is most infectious in the first month after which it remains infectious but at a much, much, much lower rate. If you could talk everyone in a population to abstain from fluid-contact sex just for a month you’d take a huge bite out of subsequent infections.

Do that just once and you could maybe/possibly/theoretically push the infection rate below sustainability. Do it once a year for a few years and you’d certainly put it on a path towards extinction!

Oh but there are a couple of catches, aren’t there? As I said above, you’d have to be pretty dispassionate not to let some of the buzzwords put you off altogether.

Abstinence? There go a ton of progressives and libertines. For only a month? There go all the social conservatives! It’s ok to use condoms (or, further crossing the line, masturbation) instead of complete abstinence? There even more conservatives. Based on observing Ramadan and Lent? There go all the free-thinkers. And even though the study took social conservatism into account (taking it into account would be the whole point driving the conclusions) it’s hard to look past stereotypes about the social conservatism of practitioners of Lent and Ramadan. And based on Ramadan? There go all the Christians and other religious faiths. Based on Lent? There go all the Moslems and other religious faiths. Based on research in Africa? You just lost the anti-colonialists, the colonialists, the racists, the anti-racists, and so on.

But…

But…

Assuming you could get past all the (in my opinion) unnecessary “buts” it’s by far the most practical, pragmatic, low-cost, and low-risk variation of a decades-old idea I’ve seen.

I mean, what’s the worst that could happen? Literally no one has ever died from abstaining from sex for a month. Even better, nobody’s ever died from using a condom for a month instead of abstaining completely. Even better, nobody’s ever died from masturbating instead of having fluid-contact and/or barrier-method sex for a month.

If some people cheated, the way all but the very most pious often do during Lent or Ramadan, the population benefit would be reduced, sure, but there’d still be some benefit.

What I particularly like about it, though, is that the same biases that make people balk could be turned to advantage.

• People who are inclined to be religious could think of it as a religious thing.
• People inclined to be kinky/libidinous could think of it as an alt-sex thing.
• People inclined to be merely pragmatic could think of it as a pragmatic thing.
• People inclined to self-sacrifice could think of it as a self-denial thing.
• People inclined to be scientific could think of it as a grand experiment (where in human subject terms participation is almost necessarily voluntary!)
• People inclined to novelty could enjoy the novelty of the situation!
• Scolds and meddlers could contribute to encouraging participation.

• Bloggers and Twitterers could post and tweet their experiences, their alternatives, their encouraging words, and, I think most importantly, could contribute heavily to the “countdown” effect (e.g. “Just 10 more days!” “Just 5 more days!”)

Pretty much worst possible outcome would be… we’d have wasted a relatively small amount of money and time, given up a relatively small amount of fluid-contact sex, and HIV rates would stay right where they are.

Call me a prudish libertine but I think it’s brilliant.

Via Tyler Cowen of Marginal Revolution.