Edward C. Green

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Edward C. Green is an American Medical Anthropologist who was educated at Northwestern University and George Washington University[1] .
For the last three decades, his focus has been on issues of international development as he has worked with the Department of Population and Reproductive Health at Johns Hopkins University[2] . Much of his work has been in HIV/AIDS and sexually transmitted diseases with an emphasis on Africa[3] .



Research & Work


Green did his dissertation work in Suriname among the Matawai Maroons. Spending two years with these descendants of escaped African slaves, Green studied indigenous healings in the Amazon. Subsequently, he worked in places such as Mozambique, Swaziland, Nigeria and South Africa where he developed programs promoting collaboration between biomedical personnel and indigenous healers. He is known for his contributions to both anthropology and public health with his work on the function and health benefits of traditional healers.

Green is also credited with developing a counter-theory regarding the underlining causes of AIDS transmission in Africa. Accepted wisdom depended on a biomedical approach to AIDS prevention. Green noted that it was cultural changes – increased monogamy and delaying sexual activity – that led to declining cases of AIDS as opposed to availability of condoms and other transmission prevention efforts. In AIDS, Behavior and Culture, Green argues for a behavior-based approach as an alternative framework for HIV prevention[4] .

This led to one of the major controversies surrounding Green when he took a position that promoting faithfulness and abstinence is both a more cost effective and more successful strategy than what was currently used in Africa. This placed him is direct opposition to a widely accepted operational tactic of public health and attacked a core component of HIV/AIDS prevention methodology. Green wrote editorials and appeared on television programs giving examples of case studies that supported his theory. The controversy was made a greater conflict as he offered support to a comment from Pope Benedict XVI about the failure of condoms as a primary HIV-prevention measure in Africa. Green claimed that the use of condoms in Africa was not effective as a primary HIV-prevention method.


In Africa, Green claimed that "risk compensation", the thought that the individual is safe by some condom use, begin to engage in riskier sex. Also, due to not wanting to give they appearance of not trusting their partner, condoms are seldom used in steady relationships. It is in these relations that perpetuate the HIV epidemic. Green is not "anti-condom", but he is not

Green’s approach can be contrasted to the typical public health approach to HIV/AIDS prevention and strategies. He makes the case, in AIDS, Behavior and Culture, that the most effective programs encourage behavioral changes seen as fundamental. Those suggested behavior-based approach directives include faithfulness, avoidance of overlapping or concurrent sexual partners and delay of initial sexual encounters[5] . These programs would build on existing cultural structures and be locally based and low cost[6] . Green argues that anthropologists and public health practitioners focusing on counseling, testing, condoms and treatment tended to impose their own Western values and ideologies[7] .


These prevalent Western approaches, according to Green, increased risk compensation, or the adjustment of individual’s behavior to perceived level of risk. Green argued that condoms as a primary strategy without the encouragement of behavior changes, led to risker behavior due to the feeling of protection. This risk compensation factor, as Green argues, has led to the failure in reducing HIV prevalence.

Conversely, Green will often cite the success in Uganda to promote the triumph of the ABC method. This approach sets forth “A” – abstinence, “B” – be faithful, “C” – use a condom, as a strategy. With the ABC method, often abstinence and faithfulness are promoted as primary, while condom use is for those that are unable to practice abstinence or fidelity. Green links ABC efforts to his own theories on behavioral change in regards to HIV/AIDS prevention.

Green’s critics point to the lack of his understanding on the weight of social pressures that inhibit these suggested behavioral changes. In The Secret: Love, Marriage, and HIV, the authors attempt to show women, and their sexual health, are bounded in the socially accepted practices of unfaithful spouses[8] . In the same way Pfeiffer, in Condom Social Marketing, Pentecostalism, and Structural Adjustment in Mozambique, highlights the structural determinants of health-related behaviors[9] . Everyday and structural violence can create environments that marginalize individuals based on issues such as gender or race which impact sexual behavior and their ability to change that behavior.



Biography


Born in 1944, Green spent his younger years in Massachusetts and attended High School in Seoul, Korea. He received a B.A. in Anthropology from George Washington University and his M.A. in Anthropology from Northwestern University. At the Catholic University of America, Green attained his Ph.D. He taught anthropology and public health at both Boston University and West Virginia University[10] .

Green is currently associated with the Department of Population and Reproductive Health at Johns Hopkins University. He also has served as a Senior Research Scientist at the Harvard School of Public Health and with the Harvard Center for Population and Development Studies, Green was the director of the Aids Prevention Research Project. Green worked as a public health advisor to the governments of both Mozambique and Swaziland[11] .

In terms of major appointments, Green served as a member of the Presidential Advisory Council on HIV/AIDS from 2003-2007. During that same time, Green served with the National Institute of Health on their Office of AIDS Research Advisory Council. He currently sits on the board of AIDS.org and the Bonobo Conservation Initiative and founded the New Paradigm Research Fund which focuses on the eradication of HIV/AIDS and poverty in Africa using African culture and indigenous knowledge.

Green has written 8 books and is the author of 400 articles, chapters and reports. He has testified before Congress four times and has appeared NPR and Dan Rather[12] .


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Major Publications

  • 2011- AIDS, Behavior and Culture
  • 2011- Broken Promises: How the AIDS Establishment Has Betrayed the Developing World
  • 2003 – Rethinking AIDS Prevention: Learning from Successes in Developing Countries
  • 1999 – Indigenous Theories of Contagious Disease
  • 1996 – Indigenous Healers and the African State: Policy Issues Concerning African Indigenous Healers in Mozambique and Southern Africa
  • 1994 – AIDS and STDs in Africa: Bridging the Gap Between Traditional Healing and Modern Medicine
  • 1986 – Practicing Developmental Anthropology
  • 1979 – Planning Psychiatric Services for Southeast Africa



Online Resources

1. New Evidence Guiding How We Conduct AIDS Prevention - http://www.newparadigmfund.org/research/green-WKKFpresentation-091907.pdf Presented to WK Kellogg Foundation (Pretoria, South Africa), 9/19/07

2. The New Paradigm Fund Website - http://www.newparadigmfund.org/

3. Vatican Conference on AIDS stresses responsible sexuality -http://saltandlighttv.org/blog/tag/edward-green



4. Beyond ABC: New Approaches to Preventing HIV - http://youtu.be/BG5gocseDFQ

For many years, governments and non-governmental organizations have promoted an ABC approach to preventing HIV and AIDS. ABC stands for Abstain from sex until marriage, Be faithful to a single partner, and use a Condom every time you have sex. ABC has some known limitations. This video discusses those limitations and additional things that can be done to prevent the spread of HIV.




5. HIV Risk Behaviors Research in Kenya - http://youtu.be/5CD7KmL228s

Duke Global Health Institute Postdoctoral Fellow Eve Puffer found that culture, economy and religion play a major role in sexual activity among youth in Muhuru Bay, Kenya, where there is a high prevalence of HIV/AIDS.





Further Reading

  • “The Pope May Be Right” by Edward C. Green
  • “Review of Rethinking AIDS Prevention: Learning from Successes in Developing Countries” by Morton Glanz
  • “Risk Compensation: the Achilles’ heel on innovations in HIV prevention?” by MM Cassell
  • “Condoms and seat belts: The Parallels and the Lessons” by JJ Richens


References

  • Curriculum Vitae: http://www.newparadigmfund.org/Edward-C-Green-CV.pdf
  • Green, Edward C. and Allison Herling Ruark
    2011 AIDS, Behavior, and Culture: Understanding Evidence-Based Prevention. California: Left Coast Press.
  • Harvard AIDS Prevention Research Project Website: http://www.newparadigmfund.org/faculty-staff/edward-c-green-nprf.html (Accessed - March 24, 2013)
  • Hirsch, Jennifer S. and Holly Ward, Daniel Jordan Smith, Harriet M. Phinney, Shanti Parikh, Constance A. Nathanson
    2010 The Secret: Love, Marriage, and HIV. Tennessee:Vanderbilt University Press.
  • Pfeiffer, J
    2004 Condom Social Marketing, Pentecostalism, and Structural Adjustment in Mozambique. Medical Anthropology Quarterly 18(1):77-103.


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  1. ^ http://www.newparadigmfund.org/faculty-staff/edward-c-green-nprf.html (Accessed - March 24, 2013)
  2. ^ http://www.newparadigmfund.org/faculty-staff/edward-c-green-nprf.html (Accessed - March 24, 2013)
  3. ^ Edward Green Curriculum Vitae
  4. ^ http://www.newparadigmfund.org/faculty-staff/edward-c-green-nprf.html (Accessed - March 24, 2013)
  5. ^ Green, Edward C. and Allison Herling Ruark
    2011 AIDS, Behavior, and Culture: Understanding Evidence-Based Prevention. California: Left Coast Press.
  6. ^ Green, Edward C. and Allison Herling Ruark
    2011 AIDS, Behavior, and Culture: Understanding Evidence-Based Prevention. California: Left Coast Press.
  7. ^ Green, Edward C. and Allison Herling Ruark
    2011 AIDS, Behavior, and Culture: Understanding Evidence-Based Prevention. California: Left Coast Press.
  8. ^ Hirsch, Jennifer S. and Holly Ward, Daniel Jordan Smith, Harriet M. Phinney, Shanti Parikh, Constance A. Nathanson
    2010 The Secret: Love, Marriage, and HIV. Tennessee:Vanderbilt University Press.
  9. ^ Pfeiffer, J
    2004 Condom Social Marketing, Pentecostalism, and Structural Adjustment in Mozambique. Medical Anthropology Quarterly 18(1):77-103.
  10. ^ http://www.newparadigmfund.org/faculty-staff/edward-c-green-nprf.html (Accessed - March 24, 2013)
  11. ^ http://www.newparadigmfund.org/faculty-staff/edward-c-green-nprf.html (Accessed - March 24, 2013)
  12. ^ http://www.newparadigmfund.org/faculty-staff/edward-c-green-nprf.html (Accessed - March 24, 2013)