AEGiS-WSJ: U.S. Abstinence Tack In AIDS Prevention Is Criticized by GAO

Important note: Information in this article was accurate in 2006. The state of the art may have changed since the publication date.

U.S. Abstinence Tack In AIDS Prevention Is Criticized by GAO

Wall Street Journal - April 5, 2006
Steve Stecklow, steve.stecklow@wsj.com

The federal government's increased emphasis on promoting sexual abstinence as a global AIDS-prevention strategy is hampering efforts to create comprehensive disease-prevention programs and causing some confusion in the field, a report by the Government Accountability Office found.

The report by the congressional watchdog agency didn't address the effectiveness of the abstinence programs promoted under the President's Emergency Plan for AIDS Relief, or Pepfar, which has been the subject of debate among health-care officials. Instead, it focused on the implementation of a congressional mandate that at least a third of AIDS prevention funds be spent on abstinence-until-marriage programs.

In Pepfar, a five-year, $15 billion program, the government aims to avert seven million new cases of HIV, the AIDS-causing virus, outside the U.S. by the year 2010. The program endorses the "ABC model," which stands for "Abstain, Be faithful or use Condoms." The legislation behind the program suggests that 20% of the program's funding be applied to prevention, with other funds going to treatment and care programs.

The report found that U.S. officials in 17 of 20 countries studied said that the abstinence-spending requirement "would prevent them from allocating prevention resources in accordance with local HIV/AIDS prevention needs."

The requirement also has led to reduced funding for other AIDS-prevention programs, including those aimed at reducing mother-to-child transmission of the virus, the report found. A team in one country reported that the spending requirement forced it to cut funds from a program to care for AIDS patients to address a local condom shortage.

The report also found confusion in many countries over the "ABC model," including which condom-promoting activities were permitted.

In an attached response to the GAO report, government officials who oversee Mr. Bush's AIDS program said it was on track to achieve its prevention goal and noted that funding for all prevention methods had increased from previous federal initiatives. The response also said program officials were committed to improving communication to the field.

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