PEPFAR’s HIV Prevention Method ‘Especially Important’ in ‘Generalized’ African Epidemics, Letter to Editor Says

Although Cambodia is an "HIV prevention success story," HIV infections in the country are "largely limited to identifiable subpopulations," which contrasts to the "truly generalized epidemics" of many African countries, Ambassador Mark Dybul, who serves as the U.S. global AIDS coordinator, writes in a New York Times letter to the editor in response to a Dec. 19, 2006, Times opinion piece (Dybul, New York Times, 12/24/06). In the opinion piece, Times columnist Nicholas Kristof writes that the President's Emergency Plan for AIDS Relief is the "single best thing" President Bush has done but adds that PEPFAR has been "undermined by a resistance to condoms." According to Kristof, Cambodia has achieved success in HIV prevention "partly by vigorously promoting condoms," and despite "all the fears that condoms lead to promiscuity, the opposite has been true in Cambodia" (Kaiser Daily HIV/AIDS Report, 12/19/06). Dybul writes that it is "especially important" all three elements of PEPFAR's prevention policy -- which include abstinence, fidelity, and "correct and consistent" condom use -- be employed in African countries where sexually transmitted HIV is "affecting all elements of society." Condoms are "an integral part of this approach, which the United States applies in ways tailored to local circumstances," Dybul writes, concluding that the "most encouraging recent news in the fight against AIDS" is the "growing adoption" of all three phases of the PEPFAR prevention policy in some sub-Saharan African countries and a resulting decline in HIV prevalence (New York Times, 12/24/06).