A report from researchers at the Sexuality Information and Education Council of the United States examines how $577 million in PEPFAR funding between 2004 and 2008 was used in Zambia, PlusNews/IRIN reports. According to the findings, the authors write, "we observed and documented some impressive prevention programming funded through PEPFAR ? Nonetheless, when stepping back and observing the whole picture, it becomes apparent that the overall approach of PEPFAR dollars to HIV prevention is far from comprehensive. Instead, it is overly restrictive, adhering to a narrow vision of a moralistic ideal, rather than responding to the reality of the epidemic and the needs of the entire population."

The report found $20.5 million of PEPFAR funds in 2008 were spent on programs focused on promoting "abstinence and being faithful" compared to $12.4 million on "other approaches, including the use of condoms," IRIN writes. "The disproportionate emphasis on abstinence-until-marriage ... has created a distinctly anti-condom atmosphere," according to the authors.

For instance, "Researchers visited one of Zambia's major trucking routes, where high rates of poverty have caused the commercial sex trade to flourish, and found that only one of three organizations distributing condoms to sex workers received PEPFAR funding, and that the supply of condoms constantly ran out," IRIN writes. The article also documents the confusion organizations on the ground have over PEPFAR requirements on how money is spent.

The report appeals for PEPFAR "to develop the capacity of local NGOs to make more substantial contributions to HIV prevention in their country, provide greater transparency about how PEPFAR funds were spent, shift away from the ideological emphasis on abstinence-until-marriage, and invest more in comprehensive sex education," IRIN writes (6/30).

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