Research has shown that despite the US spending $1.4 billion to promote abstinence in Sub-Saharan Africa including Kenya and Uganda, in a bid to slow down the spread of HIV, the campaigns failed to meet their targets.
According to a report published in Health Affairs, the campaign strategy might be causing more harm than good.
Researchers Nathan C. Lo, Anita Lowe, and Eran Bendavid from the Stanford School of Medicine sought to evaluate the impact of $1.4 billion the US used in sub-Sahara Africa aimed at discouraging pre-marital sex and promote faithfulness in marriage.
The study used health records from 22 African countries that receive funding for sex abstinence promotion from a US scheme known as the ‘President’s Emergency Plan for AIDS Relief better known as PEPFAR, and those that do not.
“The study failed to find evidence of a relationship between PEPFAR abstinence and faithfulness funding and reduction in high-risk sexual behaviors,” the report says.
The findings are based on observations of nearly 500,000 Africans under 30, among them 35,000 Kenyans. Kenya was given $5 million for HIV/AIDS prevention and treatment.
Last year, through PEPFAR, 860,000 Kenyans were given anti-retroviral drugs, and 225,000 men were circumcised.
The study which was published this week found that PEPFAR funding had no significant effect on how early young people became sexually active, or the number of sexual partners people had. In fact, the study noted that the rate of teen pregnancy was the same in countries that received the funding and those that didn’t.
Data from the 14 countries that received PEPFAR funding was compared with data from eight sub-Saharan countries not included in the plan.
“We detected no relative change over time in the number of sexual partners in the past 12 months, age at first intercourse or proportion of teenage pregnancy between people in countries with PEPFAR -funded abstinence programs and those in states without such funding,” the study goes on.
“Results suggest that PEPFAR funding likely did not reduce the high-risk sexual behavior.”
ABC campaign not as easy as it sounds
Referencing Uganda’s ABC campaign which stands for Abstain, Be Faithful, Use a Condom), the authors noted that despite it being an effective method to discourage high-risk behavior in the past, in their recent study, they found no effect on HIV transmission. According to the researchers, the campaign did not translate to fewer infection rates in the country as a result of the abstinence and fidelity drive.
“Changing sexual behavior is not an easy thing,” says Bendavid, an assistant professor of medicine at Stanford and one of the study’s authors. “When individuals make decisions about sex, they are not typically thinking about the billboard they may have seen or the guy who came by the village and said they should wait until marriage.”
What can help instead?
The study found that one of the important factors in discouraging risky sexual behavior is the number of years women stay in school.
Another effective method is treating HIV-positive pregnant women to reduce mother-to-child transmission.
Additionally, promotion of circumcision also proved to be a great way of reducing transmission.
Responding to the latest findings, PEPFAR officials argued that their scheme “has continually evolved its approach to HIV prevention, based on the latest scientific evidence and past lessons.”
“We hope our work will emphasize the difficulty in changing sexual behavior and the need to measure the impact of these programs if they are going to continue to be funded,” Lo said.
The study suggests that “the funds focused on such efforts might have been better directed to interventions proved effective in limiting the spread of HIV.”
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