The abstinence gluttons
Esther Kaplan printable version print page     Bookmark and Share
Tue Dec 20, 2005 at 12:08:31 AM EST

It would be ridiculous if it weren't so cruel. When Bush first got his global AIDS plan approved by Congress, Republicans tacked on guidance that at least a third of its prevention funds--a total of some $1 billion--should be spent on unproven abstinence-only-until-marriage messages. Now a leaked government document from the Office of the Global AIDS Coordinator shows that as of October 1 of this year, abstinence will now command two-thirds of sexual prevention dollars abroad.
"For years, the approach was condoms only," deputy coordinator Mark Dybul told the Baltimore Sun, which first acquired the document. "That needs to change." (Click here to download the relevant pages of the document, courtesy of the Global AIDS Alliance.) Why exactly a proven prevention approach based on condom access plus complete prevention education (it was never "condoms only") needs to change we'll leave to the AIDS officer who leaked the doc to the Baltimore Sun: "This is no longer about preventing HIV," he said. "It's about the Office of the Global AIDS Coordinator responding to a conservative social agenda. And it will absolutely cost lives, in Africa and beyond."

No kidding. According to the best research we have, from sociologist Peter Bearman at Columbia University and published earlier this year in the Journal of Adolescent Health, the vast majority of participants in abstinence-only programs who pledge virginity go on to have sex. And when they do have sex, they're so unprepared for the experience that they are far less likely to use a condom, and far less likely to seek out medical attention for potential STDs than people who never pledge virginity in the first place. The harm may be limited when you push this stuff on American teens in exurbia. But it's almost incalculable when you try it in a country like Botswana with a 37 percent HIV infection rate, as Bush is doing.

According to the leaked document, Bush administration policy is no longer ABC--abstinence, be faithful, use condoms--a strategy once described to me by a Ugandan AIDS advocate as a three-legged stool. It is now "Abstinence, Being faithful and the correct and consistent use of Condoms for populations engaged in high-risk behaviors." Condoms have become the stool's broken leg, the poor stepchild, reserved for sex workers even in countries where the HIV prevalence is so high that marriage itself is an HIV risk factor.

A devastating new report from the Maryland-based Center for Health and Gender Equity analyzes actual spending on the ground under the president's global AIDS plan. CHANGE found that in 2004, long before this new directive went into effect, 56 percent of all sexual prevention dollars went to abstinence-until-marriage campaigns--far above the congressional guideline. In Nigeria in 2005, the share of prevention spent on abstinence-until-marriage was 69 percent.

Meanwhile, as the AIDS epidemic continues to explode, the United States is sending fewer condoms abroad now than it did 15 years ago, according to the CHANGE report.

As Michelle Goldberg pointed out in a recent post, it's hardly incidental that many of these abstinence-only grants are going to politically connected Christian right organizations such as Franklin Graham's Samaritan's Purse and the Children's AIDS Fund, to the tune of approximately $10 million each. (The latter group won its grant despite its proposal being rated "not suitable for funding" by the expert review committee, according to the Washington Post. But the head of USAID, Andrew Natsios, intervened to overrule the experts and insist that the group receive the grant.) And as Helen Epstein and others have reported, many of these programs are only thinly veiled attempts at Christian evangelizing. Graham himself, an early booster of Bush's global AIDS program, said in testimony before the Senate in 2000, "This crisis will be curbed only when the moral teachings of God's Word permeate African society."

It's a twofer--political pork and state-sponsored proselytizing--and the only people who pay are the millions who become infected with HIV in Africa for want of condoms and information, and who then face a future without treatment because of Bush's desire to get the smallest bang for his medical assistance dollars by buying only patent-protected HIV meds.

Mitt Romney, current governor of Massachusetts, promotes "abstinence only" education in the Bay State :

"The Romney administration plans to introduce a new abstinence education program in Massachusetts schools beginning next month, the state's most aggressive effort yet to use a controversial method of teaching Bay State teenagers about sex.

The campaign, scheduled to last through June 2007, will only target certain schools and will be aimed especially at teens in black and Hispanic communities, who tend to have higher rates of sexual activity. The proposal by the state Department of Health, quietly posted on its website earlier this month, would add an abstinence education program for 12-to-14-year-olds in an unspecified number of schools.
The campaign would be funded by a $50 million federal abstinence-only grant program, which provides money to states for initiatives that teach abstinence but deliberately do not address condoms and other methods of contraception" [ Boston Globe, Dec. 21, 2005 ]

by Bruce Wilson on Wed Dec 21, 2005 at 11:46:51 AM EST
Hey it may sound noble, but targeting high-risk groups with abstinence-only is exactly the wrong thing for them to do. To the extent that there's any positive data about these abstinence pledge programs it's that when they target young kids, say in junior high, who have never been sexually active, they may delay their sexual initiation by a year and a half or so. But there's no data that the programs work with kids who are already having sex. (In fact, such messages likely put these kids at greater risk for STDs, as I explained above.) These are the kids who need detailed information about birth control and condoms, including the kind of how-to lessons that make the pro-abstinence crowd blow a gasket. The condom failure rates that abstinence advocates love to refer to are all a product of using condoms inaccurately--which can easily be solved with clear information and demonstrations.

by Esther Kaplan on Fri Dec 23, 2005 at 12:44:19 AM EST

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