African Nations' Experience With ABC Prevention Method Mixed

[Guest guest]

African Nations' Experience With ABC Prevention Method " Mixed " as

Reported at AIDS Conference

August 15, 2006

African nations on Monday at the XVI International AIDS Conference

in Toronto reported a " distinctly mixed report card " about their

experiences with the HIV/AIDS prevention strategy known as ABC --

which stands for abstinence, be faithful and use condoms -- the

Washington Post reports (Brown, Washington Post, 8/15). By law, at

least one-third of HIV prevention funds countries receive through

the President's Emergency Plan for AIDS Relief -- a $15 billion,

five-year program -- must be used for abstinence-until-marriage and

faithfulness programs (Kaiser Daily HIV/AIDS Report, 4/5). The

experiences of Botswana, Kenya and Nigeria with the ABC model " are

not likely to end debate over whether ABC represents a balanced

message of proven value or heavy-handed moralism out of touch with

the reality of youth, Africa and gender equality, " the Post reports.

The following was reported at the conference.

Botswana: An interim evaluation compared behavior of people

participating in Botswana's Total Community Mobilization program

with those who were not involved in the program. Through the

program, 450 counselors went door-to-door to distribute prevention

advice, encourage HIV testing and refer HIV-positive individuals to

treatment. According to the initial research, people contacted by

the program were more likely to mention abstinence and condom use as

HIV prevention methods, but they were not more likely to mention

being faithful. In addition, people who had been contacted by the

program were more likely to have obtained an HIV test in the

previous year and to have discussed HIV testing with a sex partner.

However, those individuals were not more likely to remain faithful

to a partner, and, when they had additional sex partners, they were

no more likely to use a condom than those who had not been contacted

by the program.

Kenya: According to a survey about ABC messages conducted among

1,400 teenagers, half of the respondents could define abstinence

correctly and state why it was important as an HIV prevention

method, though only 23% could explain faithfulness and its

importance, and only 13% could explain the importance of condoms. In

addition, about half the teenagers " spontaneously offered negative

opinions about condoms, " the Post reports.

Nigeria: In Nigeria, a seven-year project funded by USAID and the

U.K. Department for International Development counseled young people

ages 15 to 24 with the ABC message and measured their attitudes and

behaviors about 18 months before and after the program, comparing

the measures with those of people not involved in the program.

Researchers found that young women who received counseling increased

their condom use in their last nonmarital sexual encounter by 15

percentage points and that men increased their condom use by 11

percentage points. People who were not counseled did not increase

their condom use, and researchers did not observe a reduction in the

number of sex partners among those who were counseled.

Philadelphia Program To Be a Model

Prevention strategies in a Philadelphia sex education curriculum are

being adopted for use in Kenya, the Post reports. According to a

study of the program -- under which 662 black sixth and seventh

graders in Philadelphia received several sex education messages --

about 48% of the group receiving abstinence-only messages had had

sexual intercourse at least once, compared with 61% who had received

a message mentioning condoms and other prevention strategies.

According to researchers, the students in the abstinence-only

program who had had sex were as likely to know about condoms and use

them as those receiving the full ABC prevention strategy (Washington

Post, 8/15).

Advocates', Experts' Response to ABC

The focus on abstinence under the U.S. HIV prevention strategy

hinders efforts to curb the pandemic, HIV/AIDS advocates attending

the AIDS conference said Sunday, AFP/Khaleej Times reports

(AFP/Khaleej Times, 8/13). Jodi son, executive director of the

nongovernmental organization Center for Health and Gender Equality,

said abstinence and fidelity are not viable options in many

cultures, adding, " [T]he U.S. has put $15 billion in HIV, ... but

more money is not always a good thing when it follow bad policy. "

son also said that the current ABC model " fails to address

fundamental realities in a meaningful way. " Ditmore of the

Network of Sex Work Projects, and some other advocates also said

other U.S. policies, such as one that prohibits federal funding for

groups that do not denounce commercial sex work, also undermine

efforts to fight the spread of HIV among groups at an increased risk

of contracting HIV (AFP/Khaleej Times, 8/13). " No government in the

Western world has the right to dictate policy to African governments

around the way in which they respond to the pandemic, " U.N. Special

Envoy for AIDS in Africa said Monday at the

conference, adding, " That kind of insipient neocolonialism is

unacceptable. ... We're saying to Africa: 'This is how you will

respond to the pandemic,' and that's not appropriate because African

governments are eminently capable of deciding what their priorities

are and what the response should be " (Agence France-Presse, 8/14).

Mark Dybul, the ambassador for the Office of the U.S. Global AIDS

Coordinator, has said, " The notion that there's an excessive focus

on abstinence is just untrue, " adding, " The debate in Western and

Northern capitals about A versus C just misses the point entirely

and actually misses the reality on the ground in Africa. " Dybul said

that the ABC approach has been adopted in many African countries --

such as Uganda, where HIV prevalence has decreased. The Rev. J.P.

Heath of the South African Network of Religious Leaders Living with

AIDS said that abstinence is effective as an HIV prevention strategy

in Africa and that it should not overshadow other components of the

ABC model (AFP/Khaleej Times, 8/13).

Kaisernetwork.org is serving as the official webcaster of the

conference. View the guide to coverage and all webcasts, interviews

and a daily video round up of conference highlights at

www.kaisernetwork.org/aids2006.

--- End forwarded message ---

[Guest guest]

African Nations' Experience With ABC Prevention Method " Mixed " as

Reported at AIDS Conference

August 15, 2006

African nations on Monday at the XVI International AIDS Conference

in Toronto reported a " distinctly mixed report card " about their

experiences with the HIV/AIDS prevention strategy known as ABC --

which stands for abstinence, be faithful and use condoms -- the

Washington Post reports (Brown, Washington Post, 8/15). By law, at

least one-third of HIV prevention funds countries receive through

the President's Emergency Plan for AIDS Relief -- a $15 billion,

five-year program -- must be used for abstinence-until-marriage and

faithfulness programs (Kaiser Daily HIV/AIDS Report, 4/5). The

experiences of Botswana, Kenya and Nigeria with the ABC model " are

not likely to end debate over whether ABC represents a balanced

message of proven value or heavy-handed moralism out of touch with

the reality of youth, Africa and gender equality, " the Post reports.

The following was reported at the conference.

Botswana: An interim evaluation compared behavior of people

participating in Botswana's Total Community Mobilization program

with those who were not involved in the program. Through the

program, 450 counselors went door-to-door to distribute prevention

advice, encourage HIV testing and refer HIV-positive individuals to

treatment. According to the initial research, people contacted by

the program were more likely to mention abstinence and condom use as

HIV prevention methods, but they were not more likely to mention

being faithful. In addition, people who had been contacted by the

program were more likely to have obtained an HIV test in the

previous year and to have discussed HIV testing with a sex partner.

However, those individuals were not more likely to remain faithful

to a partner, and, when they had additional sex partners, they were

no more likely to use a condom than those who had not been contacted

by the program.

Kenya: According to a survey about ABC messages conducted among

1,400 teenagers, half of the respondents could define abstinence

correctly and state why it was important as an HIV prevention

method, though only 23% could explain faithfulness and its

importance, and only 13% could explain the importance of condoms. In

addition, about half the teenagers " spontaneously offered negative

opinions about condoms, " the Post reports.

Nigeria: In Nigeria, a seven-year project funded by USAID and the

U.K. Department for International Development counseled young people

ages 15 to 24 with the ABC message and measured their attitudes and

behaviors about 18 months before and after the program, comparing

the measures with those of people not involved in the program.

Researchers found that young women who received counseling increased

their condom use in their last nonmarital sexual encounter by 15

percentage points and that men increased their condom use by 11

percentage points. People who were not counseled did not increase

their condom use, and researchers did not observe a reduction in the

number of sex partners among those who were counseled.

Philadelphia Program To Be a Model

Prevention strategies in a Philadelphia sex education curriculum are

being adopted for use in Kenya, the Post reports. According to a

study of the program -- under which 662 black sixth and seventh

graders in Philadelphia received several sex education messages --

about 48% of the group receiving abstinence-only messages had had

sexual intercourse at least once, compared with 61% who had received

a message mentioning condoms and other prevention strategies.

According to researchers, the students in the abstinence-only

program who had had sex were as likely to know about condoms and use

them as those receiving the full ABC prevention strategy (Washington

Post, 8/15).

Advocates', Experts' Response to ABC

The focus on abstinence under the U.S. HIV prevention strategy

hinders efforts to curb the pandemic, HIV/AIDS advocates attending

the AIDS conference said Sunday, AFP/Khaleej Times reports

(AFP/Khaleej Times, 8/13). Jodi son, executive director of the

nongovernmental organization Center for Health and Gender Equality,

said abstinence and fidelity are not viable options in many

cultures, adding, " [T]he U.S. has put $15 billion in HIV, ... but

more money is not always a good thing when it follow bad policy. "

son also said that the current ABC model " fails to address

fundamental realities in a meaningful way. " Ditmore of the

Network of Sex Work Projects, and some other advocates also said

other U.S. policies, such as one that prohibits federal funding for

groups that do not denounce commercial sex work, also undermine

efforts to fight the spread of HIV among groups at an increased risk

of contracting HIV (AFP/Khaleej Times, 8/13). " No government in the

Western world has the right to dictate policy to African governments

around the way in which they respond to the pandemic, " U.N. Special

Envoy for AIDS in Africa said Monday at the

conference, adding, " That kind of insipient neocolonialism is

unacceptable. ... We're saying to Africa: 'This is how you will

respond to the pandemic,' and that's not appropriate because African

governments are eminently capable of deciding what their priorities

are and what the response should be " (Agence France-Presse, 8/14).

Mark Dybul, the ambassador for the Office of the U.S. Global AIDS

Coordinator, has said, " The notion that there's an excessive focus

on abstinence is just untrue, " adding, " The debate in Western and

Northern capitals about A versus C just misses the point entirely

and actually misses the reality on the ground in Africa. " Dybul said

that the ABC approach has been adopted in many African countries --

such as Uganda, where HIV prevalence has decreased. The Rev. J.P.

Heath of the South African Network of Religious Leaders Living with

AIDS said that abstinence is effective as an HIV prevention strategy

in Africa and that it should not overshadow other components of the

ABC model (AFP/Khaleej Times, 8/13).

Kaisernetwork.org is serving as the official webcaster of the

conference. View the guide to coverage and all webcasts, interviews

and a daily video round up of conference highlights at

www.kaisernetwork.org/aids2006.

--- End forwarded message ---