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U.S. NGOs Reach Out to Countries Eligible for U.S. HIV/AIDS Funding to Encourage Best HIV-Prevention Policies and Practices

Bush Administration's Promotion of Abstinence-Until-Marriage and Disparaging of Condom Use Will Only Further the AIDS Pandemic

July 14, 2004

New York, NY -- Coinciding with the 15th International Conference on AIDS, the Center for Health and Gender Equity (CHANGE) and the Sexuality Information and Education Council of the U.S. (SIECUS) have begun working with NGOs and others in countries eligible for U.S. funding under The President's Emergency Plan for AIDS Relief (PEPFAR) to promote effective HIV prevention. These countries are among the poorest and hardest hit by the HIV/AIDS pandemic, and resources for combating the disease are badly needed. The PEPFAR initiative potentially offers millions in prevention programming, but only if countries are willing to implement the Bush Administration's conservative ideological agenda under the guise of HIV prevention.

"The devil is in the details," said William Smith, director of public policy of SIECUS. "The Bush Administration's global AIDS prevention strategy disproportionately emphasizes the promotion of abstinence-until-marriage and disparages condom use," Smith continued. "Debate at the conference in Bangkok has pitted condoms against abstinence, but this is not a one or the other situation. This is about providing all people with the comprehensive sexual health information, services, technologies, and skills they need to prevent the transmission of HIV," Smith continued.

"The U.S. approach contradicts an overwhelming amount of scientific evidence, sound public health policy, and international agreements on reproductive and sexual health and rights," asserted Jodi L. Jacobson, executive director of CHANGE. "Marriage is not a protective factor against HIV infection," notes Jacobson. "Today, women and girls make up 60 percent of those infected with HIV in sub-Saharan Africa, and in many of these countries, the majority of adolescent girls are married by the time they reach age 18. Recent data from several countries now show that married women are being infected at higher rates than their unmarried counterparts," Jacobson continued.

Earlier this year, the Bush Administration released PEPFAR as an effort to increase the U.S. involvement in global HIV/AIDS prevention, treatment, and care efforts. This strategy, however, contains several provisions that are of deep concern to advocates, researchers, and service providers seeking to promote reproductive and sexual health and rights worldwide. For example:


  • No more than 20 percent of all U.S. global AIDS funds may be spent on prevention, and of those funds, a minimum of 33 percent must be spent on abstinence-until-marriage programs.

  • The strategy categorizes programs designed to prevent maternal-to-child transmission as prevention, rather than under treatment, further limiting the total amount going to prevention.

  • The strategy does not support providing information about safer sex strategies or condom use as part of a broad campaign targeting the general population. Instead, the strategy allows programs to promote condom use as an HIV-prevention tactic only to narrowly defined "high risk" groups which, according to PEPFAR include "prostitutes, serodiscordant couples, and substance abusers, among others."

  • Faith-based groups who receive U.S. funds may exclude information about contraceptive methods including condoms, if such information is inconsistent with their religious beliefs.

The focus on abstinence-until-marriage programs contradicts evidence on best practice in HIV prevention. Numerous studies show that abstinence-only-until-marriage approaches used in the United States have never been proven effective in preventing either sexually transmitted infections or unintended pregnancies among teens. Recent research suggests that these programs may actually negatively impact young people. Despite this negative evidence, the Bush Administration continues to promote and fund these programs, disparage comprehensive approaches, and discourage condom use. Moreover, the Administration's plan lacks any coherent strategy for increasing women's access to female condoms, or for empowering women to negotiate safer sex.

"The Administration points to the PEPFAR program as a mainstay of its 'compassionate conservatism' agenda," notes Jacobson, "but denying people access to lifesaving information and technologies is not compassionate, it is criminal."

"With this initiative, CHANGE and SIECUS will provide those seeking U.S. abstinence-until-marriage funding with accurate information and with examples of programs that can be utilized without causing long-term harm to people," Smith said. "But this is only a band-aid on a larger problem. Prevention programs should reflect the best scientific and public health evidence on effective HIV/AIDS prevention and treatment strategies, and must respect the rights and needs of all people, especially of women and girls who are most vulnerable to infection," Smith continued.

"The U.S. is wholly out of step with the rest of the world in the fight against HIV transmission," Jacobson said. "We hope our initiative will help to halt the potential damage the Bush Administration's pro-marriage, anti-condom approach may cause, and allow these countries to use the U.S. resources in the best way possible to meet the needs of their citizens," Jacobson continued.

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