New HIV/AIDS Directive Highlights Need for Congressional Action

Washington DC - December 19, 2005

A new directive from the Office of the U.S. Global AIDS Coordinator (OGAC) enforcing abstinence-until-marriage and be-faithful (AB) program funding will impose significant new restrictions on the use of U.S. HIV/AIDS prevention funds. The directive earmarks two-thirds of all prevention funding for the sexual transmission of HIV to AB programs, thus allocating less than 10 percent of all prevention funds to comprehensive, sound prevention programs. PAI calls on Congress to reject these new restrictions, which seem to contradict congressional intent that funding for comprehensive HIV prevention activities not be dwarfed by risky and unproven AB programs.

As part of its new directive, OGAC has divided HIV/AIDS prevention funds equally between: (1) sexual transmission of HIV; and (2) blood safety/ prevention of mother-to-child transmission (PMTCT). Current law broadly states that one-third of prevention funds are restricted to AB programs. However, the key question is Congress’ original intent: were AB funds to constitute one-third of sexual transmission prevention funds or one-third of all prevention funds?

The statutory earmark of one-third of bilateral HIV/AIDS prevention funds for "abstinence-until-marriage" activities was added to the global HIV/AIDS bill by a floor amendment offered by Rep. Joe Pitts (R-PA), which narrowly passed the House by a vote of 220 to 197 in 2003. During the extensive House floor debate on the Pitts amendment, none of the 17 speakers mentioned any other aspect of prevention other than activities to prevent sexual transmission of HIV/AIDS. In fact, even the most ardent supporters of the abstinence earmark, such as Rep. Pitts and Sen. Sam Brownback (R-KS), went to great lengths to emphasize the relatively small amount of money earmarked for abstinence programs.

This limitation on U.S. assistance will further erode funding for comprehensive programs to prevent the sexual transmission of HIV/AIDS, restricting access to the best prevention services possible. According to UNAIDS, young people ages 15-24 are “the most threatened by AIDS,” and “are at the centre of HIV vulnerability.” Globally, this age group accounts for half of all new cases of HIV each year. In many sub-Saharan countries, at least half of all women have sex before age 20 and before marriage. Even after marriage, women remain at great, sometimes increasing, risk of HIV infection. The new U.S. directive only serves to further endanger their lives by emphasizing approaches ill-suited to the realities of those most at risk.

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.