"Abstain, be faithful, or use is-thay ondom-cay"

GAO report criticizes limits, ambiguities in congressional mandate for AIDS prevention abroad.

Published April 5, 2006 4:48PM (EDT)

Lest you think that abstinence-only sex education programs serve merely to spread disease and pregnancy among U.S. teens, or that promotion of American "values" abroad results only in stirring up terrorism and civil war, the Government Accountability Office has concluded otherwise. In a report released yesterday, Congress' investigative arm stated, according to today's New York Times, that "insistence by Republican Congressional leaders that American money to fight the spread of AIDS globally be used to emphasize abstinence and fidelity is undercutting comprehensive and widely accepted aid models."

As of 2003, Congress mandates that at least one-third of American AIDS-prevention financing worldwide -- which has increased sharply even since 2004 -- be devoted to programs that promote abstinence and fidelity.

Not that there's anything wrong with abstinence and fidelity! But the report found that the provisions of the mandate had stymied, limited or at least confused AIDS prevention efforts that also involve condoms. According to the report's principal author, David Gootnick, the mandate "is hampering [health officials'] ability to implement key elements of the widely accepted model of H.I.V./AIDS prevention -- the ABC approach." (That's Abstain, Be faithful, or use Condoms.)

While the current administration does not entirely rule out condoms as part of AIDS prevention (which is nice, but I can't believe I even had to write that sentence) -- in fact, federal figures show that the number distributed on the U.S.'s dime has risen during Bush's tenure -- American officials abroad interviewed for the report said that weird distinctions, e.g., between "condom education" and "condom promotion," make it hard for them to figure out exactly what they're allowed to do and say.

The report also found that the requirement had made it more difficult to tailor programs to local needs, and had forced officials in some countries to reduce spending on programs such as those that prevent the transmission of HIV from women to their newborn babies.

Mark R. Dybul, deputy coordinator of the federal AIDS program, disagreed strongly with the GAO report's conclusions, saying that the program allowed for -- and clearly spelled out -- an appropriate balance among all the elements of "ABC" and crediting this strategy with the reduction of HIV infection rates in Uganda.

Still. Especially in an administration that appears downright rigged to get its way, when Congress' own investigative arm smells a rat -- as it did with the Food and Drug Administration's handling of Plan B -- we'd better pay attention.


By Lynn Harris

Award-winning journalist Lynn Harris is author of the comic novel "Death by Chick Lit" and co-creator of BreakupGirl.net. She also writes for the New York Times, Glamour, and many others.

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