Lawmakers at Odds Over U.S. HIV Strategy

As lawmakers and the White House struggled over how to fund AIDS relief efforts in poor countries, Senate Republicans on Thursday questioned America's overseas HIV prevention strategies.

A recent study by an international research team surprised experts by suggesting that unsanitary medical practices cause more HIV infections in Africa than does unprotected sex. The World Health Organization quickly attacked the study's methodology, saying its authors used biased statistical methods and old data. WHO maintains that unsafe medical practices cause only 2-3 percent of Africa's HIV infections.

Sen. Jeff Sessions (R-Ala.) expressed skepticism about the sexual behavior-based strategy; he suggested that medical organizations were ignoring findings on unsafe health care. But a Bush administration health official stood by the WHO estimates, saying that reliable studies show that sexual behavior accounts for approximately 90 percent of African HIV infections. "We believe that the primary mode of HIV transmission continues to be sexual," said Claude Allen, deputy secretary of Health and Human Services.

The hearing comes as members of Congress work to reach agreement with the White House over a bill outlining US AIDS prevention and treatment strategies. House Republicans and Democrats announced two weeks ago they had reached agreement over a five-year, $15 billion overseas HIV authorization. That bill has since stalled due to White House insistence that it contain language allowing organizations administering AIDS programs to refrain from discussing condoms or to discourage their use altogether, said a House Democratic aide familiar with the negotiations.

The Bush administration reportedly also continues to object to the bill's call for a $1 billion annual US contribution to the Global Fund to fight AIDS, TB and Malaria. President Bush has proposed just $200 million a year for the fund.

On Wednesday, in the final hours of debate over the 2004 budget, Sen. John Kerry (D-Mass.) offered an amendment allowing about $725 million for the Global Fund next year. Fifty-one senators voted to defeat the measure, including Majority Leader Bill Frist (R-Tenn.), who helped author a similar Senate package last year.

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