U.S. Global AIDS Coordinator Tobias Defends Emphasis on Abstinence for Prevention Programs

U.S. Global AIDS Coordinator Randall Tobias on Thursday in Berlin defended the use of prevention programs that emphasize sexual abstinence in African and Caribbean countries that are set to receive assistance through the President's Emergency Plan for AIDS Relief, Agence France-Presse reports (Agence France-Presse, 4/22). The law (HR 1298) authorizing PEPFAR endorses the "ABC" HIV prevention model -- abstinence, be faithful, use condoms -- which has had success in lowering HIV prevalence rates in Uganda. The measure also specifies that one-third of the bill's HIV/AIDS prevention funding should be used for abstinence and monogamy programs (Kaiser Daily HIV/AIDS Report, 5/28/03). Tobias, who was in Berlin for the Global Business Coalition on HIV/AIDS' 2004 Awards for Business Excellence, said that promoting abstinence and monogamy are "far more effective" than distributing condoms for preventing the spread of HIV, according to Agence France-Presse. "Statistics show that condoms really have not been very effective," Tobias said, adding, "It's been the principal prevention device for the last 20 years, and I think one needs only to look at what's happening with the infection rates in the world to recognize that has not been working." PEPFAR has been criticized by AIDS advocates for placing "false hopes" on abstinence and monogamy prevention programs, according to Agence France-Presse.

'Be Abstinent'
Tobias said, "What the Ugandans have proven is that if you can get young people -- and the results show that you can -- to understand how AIDS is spread and to delay the age at which they become sexually active, and then if you can get people who are sexually active to reduce hopefully to one the number of partners, they have proven to be the two most effective approaches to prevention." Tobias added, "The message to young people in the schools is not either 'Be abstinent or here are condoms, take your pick.' It is a message of 'Be abstinent.' Delaying sexual activity is a means of eliminating the risk of infection." Tobias on Thursday is scheduled to begin a tour of Ethiopia, South Africa and Mozambique to observe U.S. AIDS programs in those countries (Agence France-Presse, 4/22).