Chicago Tribune - March 30, 2005
Laurie Goering, Tribune foreign correspondent

In a study focused on Uganda, Human Rights Watch said that African youths are increasingly being taught that abstinence until marriage is the only proper way to prevent HIV infection and that condom use is mainly for the promiscuous.

Uganda, which receives $8 million from the U.S. government each year to promote abstinence programs for youth, "is gradually removing condoms from its HIV/AIDS strategy, and the consequences could be fatal," said Tony Tate, a researcher in Human Rights Watch's children's rights division and one of the report's authors. "Delaying sex is surely a healthy choice for young Ugandans, but youth have a right to know that there are other effective means of HIV prevention."

Uganda is widely considered Africa's leader in stemming AIDS, thanks to a high-profile government-backed campaign in the 1990s that included sexually candid messages--many from top government leaders--about how the disease was spread and warnings that only behavior change could stem the virus' spread.

Since the early 1990s, when the AIDS infection rate was 15 percent, the incidence of the disease has dropped to about 6 percent, though some of that decline came through large numbers of deaths. Local organizations working with the HIV-infected believe the current infection rate estimate is too low, saying a more accurate figure, based on their experience, is at least 10 percent.

Still, Uganda remains the only country in sub-Saharan African to have seen a significant decline in its AIDS infection rate, and that has given it a substantial share of U.S. funding for HIV prevention in Africa. In 2005, the U.S. plans to spend about $159 million for HIV/AIDS treatment, care and prevention programs in Uganda, including $8 million to support abstinence education programs for youth.

Backers of the programs--including President Yoweri Museveni's wife and church leaders--insist that abstinence is the best choice for young people and that teaching them about condoms leads to confusion. Teachers in Uganda told researchers from the human-rights group that they have been instructed by U.S. contractors not to discuss condoms in schools because the country's new policy is "abstinence only" for youth, particularly young teens.

But in a nation with nearly a million AIDS orphans, some of whom sell sex to survive, and many more teens who fail to abstain, the decision to deny children information about condoms threatens to send HIV infection rates up again, researchers and Ugandan activists said Tuesday.

"I think a number of people are really worried about this approach," said Sheila Kawamara, a women's activist in Kampala and member of the three-nation East African Legislative Assembly. "The reality is there are youths out there who cannot abstain."

U.S. government AIDS officials say the increasing focus in Uganda on abstinence and faithfulness in marriage is a homegrown change and has little to do with increasing pressure by the Bush administration.

"It's paternalistic to be telling Ugandans what will work in Uganda," Dr. Mark Dybul, assistant coordinator of U.S. Global AIDS, said of the Human Rights Watch report. He called suggestions the U.S. has pushed the change in Uganda "nonsense" and insisted that efforts to promote abstinence and partner faithfulness have been successful in the U.S. and are spreading elsewhere in Africa.

But the report's authors cite government-funded U.S. studies that suggest abstinence-promotion efforts in U.S. schools have done little to delay sexual behavior among teenagers, though they may have reduced the overall number of partners.

What is clear is that Uganda's leaders are increasingly opposed to promoting condom use. Museveni, at an international AIDS conference in Bangkok last year, called condoms "inappropriate" for Ugandans and said they encourage promiscuity among the young. His wife has called instead for virginity testing for teenage girls and promotes chastity pledges for youth.

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