Undermining success

Is a U.S.-funded abstinence-only program a threat to Uganda's model fight against AIDS?

Published March 30, 2005 3:30PM (EST)

Uganda, considered a beacon in Africa for its AIDS-beating policies, is adopting sexual-abstinence-only programs financed by the United States that could undo all its successes, a report released Wednesday says. Human Rights Watch warns that the new policies, which promote abstinence until marriage rather than condom use, leave not only young unmarried people but also women married to unfaithful men without the knowledge they need to protect themselves from infection.

Research within Uganda by Human Rights Watch has found that information on condoms, safer sex and the risks of HIV in marriage has been removed from primary schools, while some materials used in secondary schools falsely suggest that condoms have microscopic holes that allow the virus through. The AIDS awareness programs in schools are funded by the United States and overseen by an American technical advisor at the Ministry of Education.

"These abstinence-only programs leave Uganda's children at risk of HIV," said Jonathan Cohen, one of the report's authors. "Abstinence messages should complement other HIV-prevention strategies, not undermine them."

Human Rights Watch says condoms have been widely available in recent years in Uganda and have helped keep HIV prevalence down to around 6 percent, after the big fall from an estimated 15 percent in 1992. The infection rate dropped when President Yoweri Museveni's government promoted openness about AIDS and awareness of the dangers of HIV infection. But recently the president and his wife have spoken out against the use of condoms, which are considered by most AIDS experts to be the most effective protection against the virus.

Human Rights Watch says Uganda is falling in with the Christian right in the United States, which backs sexual abstinence before marriage and believes that promoting condoms leads to promiscuity. Uganda, says the report, is redirecting its AIDS strategy away from scientifically sound policies. "Although endorsed by some powerful religious and political leaders in Uganda, this policy and programmatic shift [are] nonetheless orchestrated and funded by the U.S. government."

A spokesman for Museveni denied that the U.S. was influencing policy. "The president and the first lady are being misunderstood. They have been consistent in advocating for a multipronged approach," he said. "He says that those who are sexually active should be faithful to their partners; that others should abstain, and those who cannot abstain should use condoms."

But while the United Nations and most organizations fighting AIDS back the "ABC" mantra -- abstinence, be faithful and condoms -- Uganda's AIDS commission last November issued a draft "Abstinence and Be Faithful" policy document, which argues that promoting condoms and abstinence at the same time would be confusing for young people.

Government-sponsored youth rallies have also cast doubt on condom use, says the report. At one rally it was said that using a condom to protect against disease was like "using a parachute which opens only 75 percent of the time." In October the government withdrew all free condoms, saying they had failed quality-control tests, and imposed new tests on all imports.

By Sarah Boseley

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