Take Action- click here!
Despite the fact abstinence-only-until-marriage programs have not proven successful here in the U.S., the Bush Administration is exporting these programs to other countries. Abstinence-until-marriage programs are at the core of the Administration's new plan for U.S. involvement in HIV/AIDS prevention globally, The President's Emergency Plan for AIDS Relief: U.S. Five-Year Global HIV/AIDS Strategy (PEPFAR, also known as the U.S. Strategy). The U.S. Strategy will guide all foreign assistance related to HIV/AIDS, but it was primarily created to direct the spending of a new $15 billion initiative in 15 focus countries; 12 in Africa, two in the Caribbean, and Vietnam. [1]
The U.S. Strategy Prioritizes Abstinence-Until-Marriage Programs
The U.S. Strategy purports to apply the "ABC" model of HIV/AIDS prevention that has shown some evidence of success. "ABC" stands for abstain, be faithful, and use condoms. The U.S. Strategy, however, presents these three equally important risk reduction strategies as a hierarchy with abstinence-until-marriage programs at the top. It marginalizes condom education and distribution by supporting such programs only "where appropriate," and narrowly defining "appropriate" as only for "high-risk" groups, i.e. "prostitutes" and "sero-discordant couples," couples in which one partner is HIV-positive and the other is HIV-negative.[2] This isolation of "high risk" groups further marginalizes these already vulnerable people and misrepresents the level of risk in the focus countries. Given the high HIV-prevalence rates among the general population in these countries, the unfortunate truth is that everyone is "high risk."
Nonetheless, the U.S. Strategy emphasizes abstinence-until-marriage as a prevention strategy. It states, "interventions will deliver messages that promote abstinence until marriage…," and "every effort will be made to deliver a consistent 'ABC' message so that the general population receives a clear message that the best means of preventing HIV/AIDS is to avoid risk all together."[3] By promoting these programs, the U.S. government is misrepresenting an overwhelming body of available scientific evidence. Evidence from the United States and elsewhere shows that such programs have not worked to prevent either sexually transmitted diseases or pregnancy. In fact, several studies show that while teens who participate in Virginity Pledges, a common component of abstinence-only-until-marriage programs, may delay sexual debut, they are far less likely to use condoms or contraceptives when they do have intercourse, exposing them to increased risk of unintended pregnancy and STDs, including HIV. Abstinence-until-marriage programs also mistakenly assume that marriage is a protective factor against HIV.[4] In the focus countries, married monogamous women are, in fact, among the most vulnerable for HIV infection. Evidence increasingly demonstrates that because women often have few rights within marriage, marriage itself may be a key risk factor for HIV.
The U.S. Strategy Provides Substantial Funding for Abstinence-Until-Marriage Programming
The U.S. Strategy will provide not less than $133 million annually to abstinence-until-marriage programs in the 15 focus countries over a period of five years. The Global AIDS Bill, the legal mandate for the U.S. Strategy, limits prevention spending to a maximum of 20 percent of all U.S. funds allocated for global AIDS (the rest is spent on treatment and care). The bill requires that at least 33 percent of those prevention funds be spent on abstinence-until-marriage programs. Further limiting the available funding for prevention education other than abstinence-until-marriage-programs, the U.S. Strategy categorizes programs that provide HIV-positive women with drugs to stop transmission of the virus to their newborns (mother-to-child-transmission programs) as prevention rather than treatment. Although the remaining funds could be used for more comprehensive approaches, given the clear preference for abstinence-until-marriage programs in the U.S. Strategy, it is unlikely such programs will receive grants. Moreover, all prevention monies are available to faith-based organizations, which are allowed to exclude information about contraceptive methods, including condoms, if such information is inconsistent with their religious teachings.[5] Under the U.S. Strategy, abstinence-until-marriage programs will receive probably more than $665 million over five years to operate in the 15 focus countries.
- The 15 focus countries are: Botswana, Cote d'Ivoire, Ethiopia, Kenya, Mozambique, Namibia, Nigeria, Rwanda, South Africa, Tanzania, Uganda, Zambia, Haiti, Guyana, and Vietnam.
- President's Emergency Plan for AIDS Relief: The U.S. Five-Year Strategy to Fight Global HIV/AIDS, pages 28-29. Accessed on-line at http://www.state.gov/documents/organization/29831.pdf.
- Ibid, p. 29.
- For more information on PEPFAR’s failure to adequately address the needs of women, please see Debunking the Myths in the U.S. Global AIDS Strategy: An Evidence-Based Analysis, (Takoma, MD: Center for Health and Gender Equity, March 2004). Available on-line at http://www.genderhealth.org/pubs/AIDS5-YearStratAnalysisMar-04.pdf.
- HR 1298, US Leadership Against HIV/AIDS, Tuberculosis, and Malaria Act of 2003.
Print page