Billion-Dollar US Abstinence Programs Failed To Stop Spread of HIV, Study Finds

By Victoria Kim 05/05/16

Abstinence-only sex education failed to make an impact while HIV testing, medication and health care training proved to be a success.

Billion-Dollar US Abstinence Program Failed To Stop Spread of HIV, Study Finds
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There’s little evidence that abstinence-only sex education is effective—but the U.S. government still pumped billions in funding to promote abstinence in Africa, in an effort to stop the spread of HIV.

Under the President’s Emergency Plan for AIDS Relief, proposed by President George W. Bush in 2003, the government has spent over $1.4 billion to fund programs promoting abstinence before marriage and faithfulness in Africa. These include sex education classes in school, and billboard and radio public service announcements.

But according to a new study, published Monday in Health Affairs, the abstinence programs failed to make a discernible impact on the continent. A Stanford University team led by Eran Bendavid came to the findings by analyzing half a million surveys completed by people from 22 African countries—which asked questions about sexual behavior. Fourteen of the countries received PEPFAR funding for abstinence/faithfulness programs, while the remaining eight did not. 

When the team compared the survey responses, they found “no evidence to suggest that PEPFAR funding was associated with population-level reductions” in high-risk sexual behavior—which is associated with the number of sex partners, age at first intercourse, and teen pregnancies.

“The results suggest that alternative funding priorities for HIV prevention may yield greater health benefits,” the researchers concluded. Though funding for the PEPFAR abstinence programs have declined since 2008, tens of millions of dollars are still being spent on these programs in Africa. In 2013, the government spent about $40 million on them.

There’s little evidence backing abstinence-only sex education, but there’s a lot more proving it doesn’t work. One such federally-funded study published in 2007 found that students enrolled in government-funded abstinence education programs were no more likely to abstain from sex, delay intercourse, or have fewer sex partners.

Bendavid, who is a doctor of infectious disease, said sexual behavior can’t be guided by PSAs. “I think the decisions about sexual behavior and preferences are much deeper,” he told NPR. “They’re much more deeply rooted.”

The overall PEPFAR program, however, is generally seen as a success. According to a 2015 report on the program, it was able to provide services to millions of Africans, including HIV testing, dispensing lifesaving HIV drugs, and training health care workers.

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