Abstinence promotion under PEPFAR: The shifting focus of HIV prevention for youth

Abstract

Abstinence-until-marriage (AUM) – strongly supported by religious conservatives in the U.S. - became a key element of initial HIV prevention efforts under the President’s Emergency Plan for AIDS Relief (PEPFAR). AUM programs have demonstrated limited efficacy in changing behaviors, promoted medically inaccurate information, and withheld life-saving information about risk reduction. A focus on AUM also undermined national efforts in Africa to create integrated youth HIV prevention programs. PEPFAR prevention efforts after 2008 shifted to science-based programming, however vestiges of AUM remain. Primary prevention programs within PEPFAR are essential and nations must be able to design HIV prevention based on local needs and prevention science.

Young people’s perceptions of relationships and sexual practices in the abstinence-only context of Uganda

“…This programme is known as the Presidential Initiative on AIDS Strategy for Communication to the Youth (PIASCY) (Santelli, Speizer, and Edelstein 2013). PIASCY encourages abstinence until marriage, and avoids the topic of condom use.…”

Teachers’ conflicting cultural schemas of teaching comprehensive school-based sexuality education in Kampala, Uganda

“…For instance, US-funded PEPFAR allocated a substantial part of its HIV prevention budget between 2003 and 2008 to abstinence-only programmes for young people. One of its interventions concerned the HIV prevention education programme known as the Presidential Initiative on AIDS Strategy for Communication to Youth (PIASCY) (Santelli, Speizer, and Edelstein 2013). This abstinence-only programme was developed by the Ugandan government and implemented in primary and secondary public schools from 2003 onwards (Cohen 2006).…”

HIV/AIDS Status Awareness among the Youth is Critical to Prevention: A Pilot Study

“…This indicates that HIV testing and Condom use should be considered seriously as promising and innovative HIV preventive strategies among this high risk group of youth. This will be important especially coming after the Santelli et al (2013) [10]report which indicated the failure of abstinence as a HIV preventive strategy among the youth and the reality of this group being sexually active at an early age. Of major concern, is the 44% of the male and 35% of the female student population who responded to not knowing their HIV status in Table I.…”

“…Furthermore, youths are the majority of new HIV infections. Importantly, the youths are becoming sexually active approximately by their 15 th birth day indicating that stakeholders cannot continue assuming youths are not engaging in sexual activities [4].Importantly, according to [10], abstinence as a HIV prevention strategy had failed in Kenya and Uganda. This means than new and innovative prevention strategies are urgently required to stop the increased new annual HIV infections among the youth.…”