U.S. "Ignores" Scientific Evidence by Emphasizing Abstinence in Global HIV/AIDS Prevention Programs, Opinion Piece Says

U.S. Global AIDS Coordinator Randall Tobias has "ignored the evidence and misinterpreted science to advance a narrow ideological agenda" by "defending the use of [HIV] prevention programs that emphasize only sexual abstinence," Thomas Coates, a professor of medicine in the division of infectious diseases at the University of California-Los Angeles, writes in a San Francisco Chronicle opinion piece (Coates, San Francisco Chronicle, 5/25). Tobias last month in Berlin defended the use of prevention programs that emphasize sexual abstinence under the President's Emergency Plan for AIDS Relief. The law (HR 1298) authorizing PEPFAR endorses the "ABC" HIV prevention model -- Abstinence, Be faithful, use Condoms -- which has had success in lowering HIV prevalence rates in Uganda. The measure also specifies that one-third of the bill's HIV/AIDS prevention funding should be used for abstinence and monogamy programs (Kaiser Daily HIV/AIDS Report, 4/22). According to Coates, there are several "difficulties" with only promoting abstinence through HIV/AIDS prevention programs.

• First, "there is no evidence that abstinence-only sex education works to prevent" the transmission of HIV or other sexually transmitted diseases, Coates says.
  
  
• Second, there is "emerging" evidence that comprehensive sex education programs "do prevent" HIV, STDs and pregnancy, Coates says.
  
  
• Third, the ABC approach has "problems" because many women in sub-Saharan Africa are forced into having sex, and the "majority" of young, HIV-positive African women contract HIV from a spouse or steady partner, according to Coates. "Abstinence and being faithful are hardly protective under these circumstances," Coates says.
  
  
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• Finally, rising HIV prevalence rates "are not the result of condom promotion but inadequate prevention resources," Coates says, adding that "[w]here condoms have been promoted ... they have worked remarkably."
  

If the current and future U.S. administrations are "serious about using science to save lives, they will listen to the evidence and ask for the right amount of money for international prevention and care for HIV," Coates says, concluding, "That is the moral thing to do, and that is how leadership works" (San Francisco Chronicle, 5/25).

Back to other news for May 27, 2004