Associated Press Examines PEPFAR Funding in Uganda; Shift From Condom Use to Fidelity, Abstinence Education

The Associated Press on Tuesday examined U.S. HIV/AIDS funding in Uganda and the view of some advocates and officials that the country's emphasis on prevention has shifted from condom use to fidelity and abstinence. While U.S. officials acknowledge condoms "are a key weapon" to contain the HIV/AIDS pandemic, they believe "prevention information is more effective when targeted at the appropriate audience," the Associated Press reports. According to Mark Dybul, deputy U.S. Global AIDS Coordinator, the President's Emergency Plan for AIDS Relief spent $9.7 million in 2005 on abstinence and fidelity programs in Uganda and $6.5 million on condoms and related services. The ABC method -- which stands for abstinence, be faithful and use condoms -- is credited with reducing HIV prevalence in Uganda by half since 1992, according to the Associated Press. Sam Okware, a senior Ugandan Ministry of Health official who developed the ABC method, said PEPFAR has distorted the method's message. PEPFAR "really shifted the emphasis to A and B just because of the amounts of money being put into these programs," Okware said. According to the Associated Press, approximately 20% of U.S. funding goes to faith-based groups, most of which provide only abstinence and fidelity programs. Groups that distribute condoms are required to discuss abstinence and fidelity, the Associated Press reports. "Of course I have no problem with the abstinence approach, but you have to be realistic and offer an alternative for different situations," Abeja Apunyo, country representative for the U.S.-based reproductive health organization Pathfinder International, said. According to Dybul, the number of condoms supplied to Uganda has increased from seven million to 47 million over the last five years. "Tough to argue we're pushing away from condoms in Uganda with numbers like that," Dybul said (Pownall, Associated Press, 2/28).