Abstinence-Only Programs Criticized at AIDS Conference

A third of funding made available through the President's Emergency Plan for AIDS Relief (PEPFAR) goes to groups and programs that teach abstinence and fidelity only. Serra Sippel, President of the Center for Health and Gender Equality, sees the emphasis on abstinence-only education as a built-in feature of PEPFAR. "If you are doing comprehensive [education] and don't focus on abstinence-fidelity you need to report to Congress to explain why you're not doing that," she says.

Abstinence-only programs ineffective

Jamaican youth advocate Jaevion Nelson says programs that emphasize abstinence until marriage fail the youth of his country because they don't address the reality that the majority of youth in Jamaica are already sexually active. Programs that offer no other component therefore alienate the majority of youth, says Nelson, and can never be effective tools for HIV prevention.

Programs based on the ABC (Abstain, Be Faithful, Use a Condom) approach, sometimes called abstinence-plus, also fall short of the mark. Critics say that such programs often emphasize the abstinence and fidelity components over the correct and consistent use of condoms. Programs may also neglect the importance of speaking openly about one's sexual history before engaging in sexual activity, and of condom use within marriage. In Sub-Saharan countries like Kenya, polygyny and other marital customs are responsible for increased spread of HIV-AIDS among young married women in particular. Access to evidence-based education and affordable antiretroviral therapy could also benefit populations at risk in Africa and elsewhere in the world.

Access to scientifically proven prevention and treatment was a major theme at the AIDS 2010 world conference in Vienna earlier this month. Participants agreed that policies in a number of countries criminalize risk behaviours and stigmatize those who are most vulnerable. Blocking access to help in this way represents a human rights issue, they say.

"The transmission of HIV largely is due to risk behaviour and the failure of states to provide harm reduction measures. Evidence-based interventions, such as voluntary HIV testing and counseling and the provision of condoms, needles, syringes and opioid substitution therapy, would provide effective means to contain the spread of HIV," says an official press release. The Vienna Declaration, which promotes harm reduction and evidence-based drug policies, was signed by more than 12,725 people by the close of the conference. Supporters can also add their signatures to the Convention online.

President Obama's Global Health Initiative

The Global Health Initiative will expand on the PEPFAR program introduced by former US President George W. Bush. In an address given at Johns Hopkins University, Secretary of State Hilary Clinton outlined President Obama's plans to provide antiretroviral drugs to developing countries, and to take a more "woman-centered" approach to health and AIDS relief. Other key points of the six-year, $63 billion program include a focus on family planning and supporting developing countries in running their own health care systems, instead of having to depend on foreign aid workers to provide health services.

Sources:

AIDS 2010 web site

Matt Cover, "Obama administration spending $63 billion on 'woman-centered' global health care program." Cybercast News Service

"PEPFAR comes under fire at AIDS 2010." Global Health TV (The Lancet)