Africans Chafe Under U.S. Abstinence Provisions
November 27, 2006
Many relief workers, activists, and scholars say the abstinence approach to HIV/AIDS prevention does not translate well to Africa. Embedded in the U.S. President's Emergency Plan for AIDS Relief (PEPFAR), the provision favored by U.S. religious conservatives dictates that one-third of PEPFAR's prevention funding go toward abstinence programs, amounting to 7 percent of the fund's overall $15 billion over five years.
While many favor the ABC philosophy -- Abstinence, Be faithful, use Condoms -- there is disagreement over the proper balance among the three factors, and fear that the campaign emphasizes Western ideals at the expense of African cultural norms. Africans have their own concept of abstinence, said University of Cape Town-Rondebosch Professor Sibusiso Masondo, who noted that abstinence programming will only be effective if couched in traditional, rather than Western, ideals.
Jodi Jacobson of the Center for Health and Gender Equity in Maryland said the rigid nature of prevention funding impedes efforts to tailor programs to local conditions. She added that critical gender issues in the male-dominated societies of Africa inhibit women from controlling their sexual relationships. Jacobson said the highest HIV/AIDS infection rates for African women in their 20s and 30s are among married women who contract HIV from their husbands.
ABC advocates point to its success in Uganda, where infection rates dropped from 15 percent to 5 percent over a 10-year period. Catholic Relief Services' AIDSRelief Project Director Jed Hoffman said despite the legislation's religious roots, abstinence programming is very effective in preventing the spread of HIV.
But many say separating funding for "A" and "B" from other prevention funding inhibits programs and hampers innovations.
The Rev. Mark Hanson, president of the Lutheran World Federation, calls the moral overtones of PEPFAR "harmful." "It conveys very much a sense that we have greater morals, greater wisdom, and greater values," he said.
Kansas City Star
11.18.2006; Jason Kane
This article was provided by CDC National Prevention Information Network. It is a part of the publication CDC HIV/Hepatitis/STD/TB Prevention News Update.