World AIDS Day: U.S. Restrictions Ultimately Snare HIV/AIDS Efforts

Washington DC - November 28, 2005

Themed “Stop AIDS. Keep the promise,” World AIDS Day 2005 – which takes place on Thursday, Dec. 1 – calls for governments and policymakers to be held accountable to commitments made towards ending the scourge of HIV/AIDS. The President’s Emergency Plan for AIDS Relief (PEPFAR) signals the United States’ commitment to HIV/AIDS prevention, care and treatment. However, in light of HIV infections doubling in the past decade and limited financial resources available worldwide, PAI calls on the Bush administration to evaluate whether current U.S. restrictions on international HIV/AIDS assistance make the best use of U.S. funds.

PEPFAR, announced by President Bush in 2003, is a 5-year, $15 billion initiative to stop the spread of HIV/AIDS in 15 of the world’s most affected countries in Africa, the Caribbean and Asia. But strings attached to PEPFAR funds weave a tangled paradoxical web for some of the world’s most vulnerable populations.

Beginning in 2006, one-third of U.S. HIV/AIDS prevention funds will be earmarked solely for “abstinence until marriage” programs. This U.S. policy proves highly irrelevant and potentially dangerous to married women worldwide. A recent report by the Joint United Nations Programme on HIV/AIDS and the World Health Organization illustrates the risk married women face in contracting HIV. Married women in Chinandegas, Nicaragua are twice as likely as sex workers – another population at high risk for HIV infection – to be living with HIV. And more than 85% of HIV positive women in the Rakai district of Uganda are currently or were previously married.

Another U.S. “string” is the recently-implemented “loyalty oath” restriction that requires U.S. organizations working overseas to publicly oppose sex trafficking and prostitution. The vague language of this requirement puts groups working on HIV prevention with sex workers at risk of being seen as “promoting” sex trafficking and thus losing U.S. support. The policy also has the potential to further stigmatize sex workers – ultimately putting them at higher risk for contracting HIV. Two lawsuits have been filed in the U.S. courts challenging the constitutionality of the loyalty oath applying to U.S. organizations.

Organizations receiving U.S. HIV/AIDS funds are explicitly exempted from the Global Gag Rule restrictions. However, with integration of family planning and HIV/AIDS programs increasingly being favored by public health practitioners, family planning organizations worldwide find themselves facing unconscionable policy and programmatic choices just to be able to serve their clients’ best interests while maintaining U.S. financial support.

World AIDS Day last year highlighted the disproportionate impact HIV/AIDS has on women and girls and called on the global community to take steps towards ending this disparity. A year later, women and girls are at no less risk of HIV infection and U.S. policies have put life-saving prevention efforts further from reach. Cutting the strings that too often snare otherwise laudable U.S. intentions is essential if women and girls worldwide are going to remain priorities in U.S. HIV/AIDS prevention efforts.Themed “Stop AIDS. Keep the promise,” World AIDS Day 2005 – which takes place on Thursday, Dec. 1 – calls for governments and policymakers to be held accountable to commitments made towards ending the scourge of HIV/AIDS. The President’s Emergency Plan for AIDS Relief (PEPFAR) signals the United States’ commitment to HIV/AIDS prevention, care and treatment. However, in light of HIV infections doubling in the past decade and limited financial resources available worldwide, PAI calls on the Bush administration to evaluate whether current U.S. restrictions on international HIV/AIDS assistance make the best use of U.S. funds.

PEPFAR, announced by President Bush in 2003, is a 5-year, $15 billion initiative to stop the spread of HIV/AIDS in 15 of the world’s most affected countries in Africa, the Caribbean and Asia. But strings attached to PEPFAR funds weave a tangled paradoxical web for some of the world’s most vulnerable populations.

Population Action International (PAI) works to improve individual well-being and preserve global resources by mobilizing political and financial support for population, family planning and reproductive health policies and programs.