SIECUS PEPFAR Country Profiles.

Beginning in 2004, the U.S. government, through the President's Emergency Plan for AIDS Relief (PEPFAR), is providing roughly $2 billion in HIV/AIDS-related funding each year for five years to support prevention, treatment, and care in each of 15 "focus countries" in Africa, Asia, and the Caribbean. The countries targeted include: Botswana, Cote d'Ivoire, Ethiopia, Kenya, Mozambique, Namibia, Nigeria, Rwanda, South Africa, Tanzania, Uganda, Zambia, Guyana, Haiti, and Vietnam. The funding specifically for HIV prevention is limited to a maximum of only 20% of all U.S. funds allocated for global AIDS programs. By law, at least 33 percent of those prevention dollars must be spent on abstinence-until-marriage programs.

In October 2005, we released SIECUS PEPFAR Country Profiles: Focusing in on Prevention and Youth. This publication provides the first, comprehensive overview of key country-level information on how U.S. HIV-prevention policies under PEPFAR, including the exportation of U.S.-styled abstinence and marriage promotion programs, are impacting efforts to stem this worldwide pandemic.

Instead of promoting a multi-pronged, inclusive approach to HIV prevention, SIECUS found that the bulk of programs funded under PEPFAR focused on promoting abstinence and marriage. In Fiscal Year 2004, according to the Office of the Global AIDS Coordinator, $193 million was committed to HIV-prevention activities under PEPFAR. Of this, $91.6 million was dedicated to preventing the sexual transmission of HIV, and $50.5 million (56%) of those prevention dollars went to abstinence-until-marriage and faithfulness promotion programs. This, despite that in the U.S., abstinence-until-marriage programs have not been proven effective. In fact, recent research has shown that these programs may have a negative impact on young people's sexual decisions.

The findings of this report highlight the pressing need for change. SIECUS calls for the following immediate actions on the part of the U.S. government:

1. Increase transparency of PEPFAR prevention funds

2. Abandon the mandate of 13 of prevention funds for abstinence-until-marriage programs

3. Enact appropriate oversight mechanisms of PEPFAR prevention grantees

4. Rescind the anti-prostitution pledge

5. Work with the international community to implement programming and policy that connects HIV/AIDS to other issues of sexual and reproductive health

6. On-the-ground monitoring of funded activities

SIECUS PEPFAR Country Profiles is available at www.siecus.org/inter/pepfar/.