The politics of U.S. HIV/AIDS prevention policy

A friend of mine, Milo, just alerted me to this recent AlterNet.org news report detailing how Brazilian officials turned down $40 million dollars from the U.S. to fight HIV/AIDS in their country. They turned down the money not because they are unconcerned about HIV/AIDs in Brazil (to the contrary, Brazil has gained worldwide attention for its innovative AIDS education, prevention and treatment policies) but because they refused to comply with the U.S.' demand that to receive the money, Brazil would have to condemn prositution and sex work.

Brazil has refused to do this because sex workers have played a key role in the training of community HIV/AIDS educators, the mass dissemination of condoms and safe sex information/education, and in working with the government and other civic organizations to develop an extensive network of groups working to prevent HIV/AIDS. By including sex workers and their organizations in HIV/AIDS prevention efforts, Brazilian officials are not condoning prostitution per se. Rather, they believe that the best way to prevent HIV/AIDS is to take a practical approach instead of what they call an "ideological" approach, the latter of which they accuse the U.S. of taking by requiring countries to condemn sex work if they are to receive U.S. funds.

Brazil officials are not the first group to criticize the U.S. government for its ideologically-driven global HIV/AIDS and public health funding. The U.S. has also received criticism from NGOs worldwide for its refusal to fund HIV/AIDS efforts in other countries--including those in AIDS-ravaged Africa--if the organizations doing this work do not take abstinence-only approaches to HIV/AIDS prevention. Such abstinence only programs can have devasting consequences for countries such as those in Africa where HIV/AIDS rates are incredibly high, and gender inequality is a cultural given. For istance, many men believe that sex is their right and many women feel that they do not have the choice to say no to unwanted sex.

In the U.S., officials from the U.S. Center for Disease Control and Prevention (CDC) were required by government higher ups several years ago to remove references to condom use from its HIV/AIDS prevention website. More recently, the Department of Health and Human Services created a website for parents providing them with information on how to talk about sex with their teen children. The site takes an abstinence-only approach and the only information it has about contraception focuses on its negative and potentially harmful aspects. The abstinence-only approach to public health has frustrated many U.S. public health workers. Although they believe that abstinence should be encouraged among teens as a means of preventing both pregnancy and STD infection, they also believe that it is not realistic to expect all teens to remain sexually chaste until marriage. Thus, they believe that abstinence-only education is a bad public health strategy, and that to promote and protect adolescent health, especially the spread of HIV/AIDS, teens must also be educated about different forms of birth control and safe sex strategies.