The Baltimore Sun on Sunday examined the work of World Relief's "Choose Life" HIV/AIDS prevention campaign in Mozambique. "Choose Life" focuses on abstinence until marriage as the best way to protect against HIV transmission. The Baltimore-based World Relief is the humanitarian assistance division of the National Association of Evangelicals and receives funding from the U.S. government (Calvert, Baltimore Sun, 4/2). The Bush administration's emphasis on promoting abstinence and fidelity in HIV/AIDS prevention programs and efforts to "de-emphasize" the use of condoms is "hindering" programs adopting the HIV prevention method known as "ABC" -- which stands for abstinence, be faithful and use condoms -- according to some HIV/AIDS advocates. An Office of the U.S. Global AIDS Coordinator directive that took effect on Oct. 1, 2005, provides guidelines on use of fiscal year 2006 federal funding for international HIV/AIDS programs that work to prevent sexual transmission of the virus. The document says that "66% of resources dedicated to prevention of HIV from sexual transmission must be used for activities that promote abstinence before marriage and fidelity" (Kaiser Daily HIV/AIDS Report, 1/3).
In 2004, the U.S. government gave World Relief $9.7 million to operate programs that support abstinence until marriage in four sub-Saharan and Caribbean nations, including Mozambique. The Choose Life program in Mozambique -- which teaches that condoms are "80% to 95% effective in reducing the risk of getting HIV through sex" and "the only 100% effective choice ... is abstinence from sexual activity" until marriage -- has contributed to more than 222,000 people ages 10 to 24 in Mozambique taking abstinence classes, according to the Sun. World Relief says it does not have proof that abstinence-until-marriage programs are working in the country. "Only when we see the [rate of new HIV cases] dipping will we know that this education is effective," Samuel Grottis, World Relief's Southern Africa director, said. Recent data suggest the HIV/AIDS epidemic in Mozambique is worsening. HIV prevalence increased from 14% in 2002 to 16% in 2004, with half of all new infections occurring in people ages 15 to 24. The "danger" in focusing on abstinence until marriage in HIV prevention, is that you are "undermining the belief in one of the few tools we have that is cheap, affordable and efficacious," Chris Beyrer, director of the AIDS International Training and Research Program at Johns Hopkins University Bloomberg School of Public Health, said. Further complicating the situation in Mozambique are the incidence of new HIV cases within marriage and gender inequality, which contributes to pressures put on girls to have sex, according to the Sun (Baltimore Sun, 4/2).
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