U.S. abstinence hurts Uganda AIDS success: report

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President Yoweri Museveni is jeopardizing Uganda’s giant strides against HIV/AIDS by backing U.S.-funded “abstinence-only” programs, a New-York based human rights group said on Wednesday.

Museveni has been widely praised for reducing infection rates to around 6 percent today from 30 percent in the early 1990s, a reversal most Ugandans attribute to his government’s frankness about the role of condoms in tackling the disease.

But Human Rights Watch (HRW) said Uganda has recently stopped giving out vital information on HIV/AIDS in primary schools, older children were being misinformed about condoms, and U.S.-sponsored rallies were spreading “falsehoods.”

"These abstinence-only programs leave Uganda’s children at risk of HIV,” said Jonathan Cohen, a researcher on the disease for HRW. “Abstinence messages should complement other HIV-prevention strategies, not undermine them.”

Uganda’s government says it has long employed an “ABC” strategy—Abstinence, Be Faithful, and use Condoms—and it says Museveni and his wife Janet, an anti-AIDS campaigner, have not changed their position.

“The president and the first lady are being misunderstood,” said a Museveni spokesman. “He says that those who are sexually active should be faithful to their partners, others should abstain, and that those who cannot abstain should use condoms.”

Uganda’s war against HIV/AIDS is a rare success story compared with other African countries, notably South Africa where more than 5 million are infected with HIV—more than 10 percent of the global pandemic.

In its 80-page report, “The Less They Know, the Better: Abstinence-Only HIV/AIDS Programmes in Uganda,” HRW said abstinence schemes had been proved ineffective and potentially harmful in numerous independent studies.

Cohen said they were “a triumph of ideology over public health.”

The results of a recent study conducted in the Rakai district of Uganda also suggest that increased condom use is primarily responsible for the decline in AIDS/HIV rates, not the promotion of abstinence and monogamy (see Reuters Health report February 24, 2005.)

POVERTY AND SEX

President Bush has more than doubled funding for U.S. abstinence-only programs over the past five years reflecting the values of his religious-right supporters.

As part of his global AIDS plan, the U.S. government has already budgeted about $8 million this year for abstinence-only projects in Uganda, HRW said.

It said Janet Museveni—a strong supporter of abstinence who hosted several hundred virgins at a Kampala school in December—and charities close to her had received U.S. funds.

Meanwhile, Ugandan teachers told HRW they had been instructed by U.S. contractors not to discuss condoms—which provide a reliable barrier to the transmission of HIV—in schools because the country’s new policy is abstinence only.

“President Museveni has publicly condemned condoms as inappropriate for Ugandans, leading some AIDS educators to stop talking about them,” it added.

Posters promoting abstinence have appeared along major Ugandan roads, but many people Reuters spoke to said defeating the disease by abstaining from sex is not realistic.

“There are so many factors to consider, particularly in Africa where people are so poor,” said John, a 30-year-old businessman. “There will always be predators ready and waiting to take advantage of that poverty.”

Other Ugandans echoed his view, telling HRW that abstinence promoters should look more closely at the living conditions in a country where most people earn less than $1 a day, and where at least 1.2 million are HIV-positive.

“Around here, people don’t buy this idea of abstinence, because in Uganda, many girls are using sex to buy their daily bread,” a head teacher in the eastern town of Mbale said.

A youth activist in Kampala said impoverished youngsters needed help and access to protection, not judgmental messages.

“Abstinence is a message for the elite. It has no place in the slums,” he said. 

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