PEPFAR Should Increase Emphasis on Condom Use, Allow Greater Flexibility in HIV Prevention Programs, Editorial Says
"Health workers ... should not have to tip-toe around [the] ill-informed and ideologically driven" HIV prevention policies of the President's Emergency Plan for AIDS Relief, and "[r]igorous implementation" of programs emphasizing condom use is "crucial" for PEPFAR to reach its target of preventing seven million new HIV cases by 2010, a Lancet editorial says (Lancet, 4/15). A Government Accountability Office report released earlier this month says that the Office of the U.S. Global AIDS Coordinator's mandates for how much PEPFAR-funded programs must spend promoting abstinence and faithfulness have caused confusion among many countries and undercut some HIV prevention programs. GAO for the report surveyed U.S. teams in the 15 PEPFAR target countries and five others that receive at least $10 million in PEPFAR funding to fight HIV/AIDS (Kaiser Daily HIV/AIDS Report, 4/5). The "lack of flexibility is clearly causing problems on the ground," including "ridiculous situations" outlined in the report in which "workers are unsure whether they will lose funding if they answer young people's legitimate questions about condom use," according to the editorial. PEPFAR is "supposed to be an 'emergency' plan" and should be "executed as such," the editorial says, concluding, "The GAO report should prompt Congress to ask whether [the funds] earmarked for prevention programs based on abstinence and faithfulness is an effective use of U.S. taxpayers' money. Many more lives will be saved if condom use is heavily promoted alongside messages to abstain and be faithful" (Lancet, 4/15).
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