JOHANNESBURG, South Africa - U.S.-supported anti-AIDS policies that promote abstinence and discourage condom use among the young are likely to lead to rising HIV infection rates in Africa, a U.S. human-rights group warned yesterday in a report.
In a study focused on Uganda, Human Rights Watch charged that African youths are increasingly being taught that abstinence until marriage is the only proper way to prevent HIV infection and that condom use is mainly for the promiscuous.
Uganda, which receives $8 million from the U.S. government each year to promote abstinence programs for youth, "is gradually removing condoms from its HIV/AIDS strategy, and the consequences could be fatal," said Tony Tate, a researcher in Human Rights Watch's children's rights division and one of the report's authors. "Delaying sex is surely a healthy choice for young Ugandans, but youth have a right to know that there are other effective means of HIV prevention."
Uganda is widely considered Africa's leader in stemming AIDS, thanks to a high-profile government-backed campaign in the 1990s that included sexually candid messages about how the disease was spread.
Since the early 1990s, when the AIDS infection rate was 15 percent, the incidence of the disease has dropped to about 6 percent, though some of that decline came through large numbers of deaths.
Still, Uganda remains the only country in sub-Saharan Africa to have seen a significant decline in its AIDS infection rate, and that has given it a substantial share of U.S. funding for HIV prevention in Africa. This year, the U.S. plans to spend about $159 million for HIV/AIDS treatment, care and prevention programs in Uganda, including $8 million to support abstinence education programs for youth.
Backers of the programs - including President Yoweri Museveni's wife and church leaders - insist that abstinence is the best choice for young people and that teaching them about condoms at the same time leads to confusion. Teachers in Uganda told researchers from the human-rights group that they have been instructed by U.S. contractors not to discuss condoms in schools because the country's new policy is "abstinence only" for youth, particularly young teens.
But in a nation with nearly a million AIDS orphans, some of whom sell sex to survive, and many more teenagers who fail to abstain, the decision to deny information about condoms threatens to send HIV infection rates up again, researchers and Ugandan activists say.
U.S. government AIDS officials say the increasing focus in Uganda on abstinence and faithfulness in marriage is a homegrown change and has little to do with increasing pressure by the Bush administration.
"It's paternalistic to be telling Ugandans what will work in Uganda," Dr. Mark Dybul, assistant coordinator of U.S. Global AIDS, said of the Human Rights Watch report. He labeled as "nonsense" suggestions the United States has pushed the change in Uganda.
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