Perspective: Abstinence and AIDS
The Boston Globe
1 December 2006
****************

FROM AFRICA, the continent most afflicted with the HIV-AIDS epidemic,
the news is mixed at best on this World AIDS Day. But in the United
States, the nation that surpasses all others in its AIDS funding in
Africa, there is one solid piece of good news. Thanks to the change of
power in Congress, US-financed prevention programs could be freed of
the requirement that one-third of all their funding go to
abstinence-only efforts.

There is a definite role for abstinence, especially among the young,
where the training has been shown in some cases to delay the age of
first sexual activity. Abstinence-only programs, however, are of
little help to some of those most vulnerable to infection, including
impoverished young women under pressure to have sex for economic or
cultural reasons.

The changeover in Congress will greatly improve the prospects of a
bill sponsored by a critic of the abstinence-only rule, Representative
Barbara Lee of California. Lee's bill would also direct President Bush
to develop a full strategy to reduce the particularly high risk of HIV
infection faced by women and girls in developing countries. In
southern Africa, 76 percent of infected persons between age 15 and 24
are female.

Lee's bill calls for greater access to female condoms and better
educational and job-training opportunities for young women. The
measure's sheer scope might endanger its chances in the Senate, where
the Democratic margin is hair-thin, but it should be possible for both
houses at least to agree on eliminating the abstinence-only earmark.

A report this year by the Government Accountability Office showed that
US officials working in AIDS prevention overseas found the earmark
confusing and difficult to balance with other programs. In nine
countries, the officials, who were granted anonymity by GAO, said the
abstinence mandate forced reductions in programs to inhibit
mother-to-child transmission of the virus.

Another problem is the administration policy opposing needle-exchange
programs, which would be an effective counter to AIDS in a country
like Vietnam, where many infections are related to drug use. Reversing
that policy might require a change in the White House, but it would be
a welcome first step in improving the US role in preventing AIDS if
Congress drops the abstinence earmark. The focus should be AIDS-only.

AIDS in the world, 2006
 
New HIV infections in 2006  4.1 million
People living with HIV/AIDS  38.6 million
AIDS-related deaths in 2006  2.8 million
AIDS-related deaths since 1981  39.8 million

SOURCE: World Health Organization and UN Program on AIDS

Online at:
http://www.boston.com/news/globe/editorial_opinion/editorials/articles/2006/12/0
1/abstinence_and_aids/