U.S.-funded “abstinence-only” programs are jeopardizing Uganda’s successful fight against HIV/AIDS, Human Rights Watch said in a new report today. Abstinence-only programs deny young people information about any method of HIV prevention other than sexual abstinence until marriage.
The 80-page report, “The Less They Know, the Better: Abstinence-Only HIV/AIDS Programs in Uganda,” documents the recent removal of critical HIV/AIDS information from primary school curricula, including information about condoms, safer sex and the risks of HIV in marriage. Draft secondary-school materials state falsely that latex condoms have microscopic pores that can be permeated by HIV, and that pre-marital sex is a form of “deviance.” HIV/AIDS rallies sponsored by the U.S. government spread similar falsehoods.
“These abstinence-only programs leave Uganda’s children at risk of HIV,” said Jonathan Cohen, a researcher with Human Rights Watch's HIV/AIDS Program and one of the report’s authors. “Abstinence messages should complement other HIV-prevention strategies, not undermine them.”
U.S. officials describe their strategy in Uganda as “ABC”—a popular acronym standing for “Abstinence, Be Faithful, use Condoms.” Some experts credit the “ABC” strategy with helping to reduce HIV prevalence in Uganda from about 15% in the early 1990s, to less than 10% today. However, Human Rights Watch’s new report documents how condoms are left out of the equation, especially for young people.
A draft “Abstinence and Being Faithful (AB)” policy released in November 2004 by the Uganda AIDS Commission cautions that providing information about condoms alongside abstinence can be “confusing” to youth. Teachers told Human Rights Watch that they have been instructed by U.S. contractors not to discuss condoms in schools because the new policy is “abstinence only.” President Museveni has publicly condemned condoms as inappropriate for Ugandans, leading some AIDS educators to stop talking about them.
Uganda faces a nationwide condom shortage due to new government restrictions on condom imports. In late 2004, the Health Ministry recalled batches of imported condoms, allegedly due to failed quality control tests. Instead of addressing the shortage, some ministers suggested that Ugandans adopt abstinence as a preferable HIV-prevention strategy.
“Uganda is gradually removing condoms from its HIV/AIDS strategy, and the consequences could be fatal,” said Tony Tate, a researcher with Human Rights Watch’s Children’s Rights Division and the report’s co-author. “Delaying sex is surely a healthy choice for young Ugandans, but youth have a right to know that there are other effective means of HIV prevention.”
The U.S. government has already budgeted approximately U.S. $8 million this year on abstinence-only programs in Uganda as part of President George W. Bush’s global AIDS plan. The National Youth Forum, headed by Ugandan First Lady Janet Museveni, a vocal proponent of abstinence-only, has received U.S. funding under the plan. The First Lady has lashed out against groups that teach young people about condoms and called for a national “virgin census” to support her abstinence agenda. The Virginia-based Children’s AIDS Fund, an organization with close ties to Janet Museveni, was recently approved for a major abstinence-only grant, despite having been deemed “not suitable for funding” by a technical panel of the U.S. Agency for International Development (USAID).
“Abstinence-only programs are a triumph of ideology over public health,” said Cohen. “Americans should demand that HIV-prevention programs worldwide stick to science.”
Uganda gained a reputation in the 1990s for its high-level leadership against HIV/AIDS and acceptance of sexually candid HIV-prevention messages. But public health experts and Ugandan AIDS organizations fear that the shift toward abstinence-only programs will reverse this success. Abstinence programs have been used since 1981 in the United States, where they have proven in numerous independent studies to be ineffective and potentially harmful.