GAO Report: Global AIDS Law's 'Abstinence-Until-Marriage' Earmark S ortc anges Ot er !

e" #re$ention Strategies G%ttmac er #olic" Re$iew

Spring 2006, Volume 9, Number 2
&or t e Recor' A Government Accountability Office (GAO) report to ongre!! "ate" April # "etail! t$e negative effect! of t$e legal re%uirement t$at at lea!t one&t$ir" of all prevention fun"! appropriate" un"er t$e 're!i"ent(! )mergency 'lan for A*+S ,elief (')'-A,) be re!erve" for .ab!tinence&until&marriage. program!/ 0$e report conclu"e! t$at !ip$oning off fun"! for t$e!e activitie! $a! force" !ome ')'-A, country team! to re"uce t$e fun"ing t$ey ot$er1i!e 1oul" $ave provi"e" to ot$er 2ey prevention intervention!/ Negatively affecte" program! inclu"e t$o!e to prevent t$e tran!mi!!ion of 3*V4A*+S "uring pregnancy an" c$il"birt$, to promote compre$en!ive me!!age! aime" at preventing t$e !e5ual tran!mi!!ion of 3*V4A*+S, an" to !upport prevention program! aime" at 3*V&po!itive people an" $ig$&ri!2 group! !uc$ a! !e5ually active yout$, 1$ic$ coul" involve t$e "i!tribution of con"om!/ *n fall 2006, t$e State +epartment(! Office of t$e 7/S/ Global A*+S oor"inator "evi!e" a formula implementing t$e ab!tinence&until&marriage re%uirement/ 0$e gui"eline! !pecify t$at ')'-A, country team! mu!t re!erve $alf of t$eir prevention fun"! for program! to prevent t$e !e5ual tran!mi!!ion of 3*V4A*+S8 t$e remain"er mu!t cover all ot$er 2in"! of prevention intervention!, !uc$ a! mot$er&to&c$il" an" bloo"&!afety program!/ *n eac$ country, at lea!t t1o&t$ir"! of t$e fun"! to prevent t$e !e5ual tran!mi!!ion of 3*V4A*+S mu!t be u!e" to promote ab!tinence an" .fait$fulne!!,. 1$ic$ t$e a"mini!tration "eem! to be t$e t1o goal! of t$e ab!tinence&until&marriage program/ 0$u!, t1o&t$ir"! of one&$alf of all t$e prevention fun"! are re!erve" to promote ab!tinence an" fait$fulne!!9or one&t$ir" of t$e total prevention allocation to eac$ country/

The report sheds important new light on the impact of making the abstinence-until-marriage program the single most important U.S. global HIV/AI S pre!ention strateg".
Numerou! member! of ongre!! on bot$ !i"e! of t$e .ab!tinence&only. "ebate $a" a!2e" t$e GAO9 ongre!!( au"it, evaluation an" inve!tigative arm9to con"uct a revie1 of t$e effect! of t$e !tatutory earmar2, inclu"ing $o1 t$e a"mini!tration $a! c$o!en to implement it/ GAO inve!tigator! !pent t$e la!t year intervie1ing official!9bot$ in t$e 7nite" State! an" in !electe" ')'-A, focu! countrie!9from 2ey government agencie!, fait$&ba!e" an" ot$er nongovernmental organi:ation! an" $o!t country government! t$em!elve!/ .Sati!fying ;t$e la1(!< ab!tinence&until&marriage !pen"ing re%uirement pre!ent! c$allenge! to mo!t country team!,. t$e GAO reporte"/ =eeting t$e earmar2, GAO inve!tigator! 1ere tol", pre!ent! country team! 1it$ a conflict in !taying true to t$e ot$er "irective un"er ')'-A,, al!o !tipulate" by la1, t$at t$ey promote a compre$en!ive A> approac$ (ab!tain, be fait$ful, u!e con"om!) to preventing t$e !e5ual tran!mi!!ion of 3*V4A*+S/ ,ecogni:ing t$e problem! in$erent in impo!ing a !trict formula on countrie! ranging from Vietnam to ?ambia to 3aiti, 1$ic$ "iffer 1i"ely in term! of t$e nature of t$eir 3*V4A*+S epi"emic! a! 1ell a! !ocial an" cultural norm!, t$e a"mini!tration $a! e!tabli!$e" a .1aiver. !y!tem 1$ereby country team! may be relea!e" from t$e formula ba!e" on t$e local epi"emiology an" !pecific country nee"!/ GAO note!, $o1ever, t$at alt$oug$ t$i! may $ave alleviate" t$e problem in t$o!e countrie! t$at $ave 1on 1aiver!, t$e remaining country team! mu!t compen!ate by !pen"ing even more t$an one&t$ir" of t$eir total prevention fun"! on ab!tinence an" fait$fulne!! program! to meet t$e !tatutory re%uirement at t$e global level/ A!!e!!ing t$e content or effectivene!! of t$e ab!tinence an" fait$fulne!! program! t$at t$e 7nite" State! i! fun"ing 1a! beyon" t$e !cope of t$i! particular report8 t$at coul" be a pro@ect for t$e future/ Still, t$e report !$e"! important ne1 lig$t on t$e impact of ma2ing t$e ab!tinence&until&marriage program t$e !ingle mo!t important 7/S/ global 3*V4A*+S prevention !trategy/ *t reveal! t$at a! long a! re!ource! are not infinite, t$e man"ate" $ig$ level of fun"ing in t$i! area i! coming at t$e e5pen!e of ot$er, proven intervention!, 1$ic$ in many ca!e! $ave been "eeme" $ig$er priority by t$e public $ealt$ profe!!ional! on t$e groun"/ 7pon t$e relea!e of t$e GAO report, Sen/ +ianne -ein!tein (+& A) imme"iately "enounce" t$e ab!tinence&until&marriage earmar2 in t$e 7nite" State! Aea"er!$ip Again!t 3*V4A*+S, 0uberculo!i!, an"

=alaria Act of 200B a! .t$e 1rong approac$. an" "eclare" t$at !$e 1oul" !oon be intro"ucing legi!lation aime" at mitigating t$e $arm it i! cau!ing/ .0$e GAO reportCclearly "emon!trate! t$at 1e are not "oing everyt$ing 1e can to protect $ig$&ri!2 population! aroun" t$e 1orl" from t$e tran!mi!!ion of 3*V4A*+S,. !ai" -ein!tein, a 2ey member of t$e Appropriation! ommittee/ Alt$oug$ ongre!! i! not re%uire" to recon!i"er t$e!e an" many ot$er i!!ue! relating to ')'-A, until 200D, 1$en t$e la1 mu!t be rene1e", ameliorative action coul" be ta2en bet1een no1 an" t$en in t$e cour!e of approving an annual appropriation for t$e program/Susan A. Cohen

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