Public health groups and conservatives have split over a two-year-old congressional mandate that denies overseas U.S. AIDS funds to "any group or organization that does not have a policy explicitly opposing prostitution and sex trafficking." Though the pledge was initially required of international recipients, it was extended to U.S.-based groups this spring.

On May 18, more than 200 U.S. groups wrote the White House to object that the anti-prostitution pledge is "undermining promising interventions" to fight AIDS. On Aug. 4, dozens of conservative groups wrote Bush urging that political appointees in federal agencies scrutinize groups to ensure their "actual field practices" do not condone prostitution.

In a May 31 letter to President Bush and Andrew Natsios, head of USAID, which provides about half of federal overseas AIDS funding, Sen. Rick Santorum (R-Penn.) accused CARE and other aid groups of having a "solid record of anti-abstinence, pro-prostitution, and anti-American activities." "We do not promote prostitution or trafficking in any way," said CARE spokesperson Beatrice Spadacini.

Also writing Bush in May, Sen. Tom Coburn (R-Okla.) accused Population Services International, which operates programs in brothels and bars in Central America, of encouraging prostitution by throwing parties for sex workers. Inferring that educational bingo games designed to reduce risk are parties, said PSI spokesperson David Olsen, is a gross misrepresentation of their work. In parts of Guatemala, where PSI has significantly expanded its work, HIV infections among prostitutes have fallen by a third.

In April, USAID requested proposals for $14 million of work in Central America over four years, to be awarded by mid-June. PSI applied to continue its eight-year program and said it was led to believe it would be funded. But on July 19, a senior political appointee at USAID withdrew the request, a public health source said. In an Aug. 11 reopening of the bidding process, USAID changed selection criteria by de-emphasizing experience; eliminating the goal to increase condom use; and adding language observing the advantage of faith-based organizations in the HIV/AIDS fight.

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