Friday, May 13, 2016

Abstinence and fidelity--zip when it comes to HIV

Yes, HIV/AIDS is still a world scourge. You just don't hear much about it in the US because we have fairly effective drugs.

But worldwide, the US Govt has invested $1.4 billion in programs promoting abstinence and marital fidelity.

There is no evidence this has been effective, Stanford researchers say.

The President's Emergency Fund for AIDS Relileft (PEPFAR)) has gradually been reducing its support for such programs. As outlined in the May issue of Health Affairs, PEPFAR thinks other prevention methods are more effective.

The use of funds has a human cost--spend them on one thing, another thing is not supported--things such as condom use, male circumcision and methods to prevent transmission from others to children.

When launched in 2004, PEPFAR had $15 billion in the kitty for programs in 15 countries. A third was to be dedicated to abstinence and fidelity programs.

In 2008, this one-third requirement was eliminated, but funds continued to flow to those programs, though at a lesser rate.

The Stanford researchers hope their findings will emphasize the difficulty of changing sexual behavior--and also highlight the need to measure the impact of programs instead of just throwing money at them.

--Of the 345,000 women studies, they found no difference in number of sexual partners among those living in PEPFAR-influenced countries over those in non-PEPFAR countries.

--They did find a slight delay in first intercourse along more women than men in PEPFAR v non-PEPFAR--but the difference was four months, not statistically meaningful.

It should be noted that abstinence programs did not work in the US either.

When people want to have sex, said one researcher, they don't think about a billboard they saw or what some guy said when he came by the village.

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