Recently, India announced that 80% of funding in the government’s new 5 year, $2.5 billion HIV/AIDS initiative will be allocated to prevention efforts. Within this framework, condoms will be the primary prevention method and the campaign will include the installation of 100,000 condom vending machines in colleges, train stations, gas stations, roadside restaurants and hospitals.¹ India has one of the highest rates of HIV infection in the world with 5.7 million estimated cases. These 5.7 million cases represent two-thirds of Asia’s entire 8.3 million person HIV prevalence.² India has made some progress in reducing its HIV incidence in its southern states through safer sex awareness campaigns. Despite the success of such campaigns, the epidemic continues to spread, in large part, through men having sex with female sex workers.³

Though not one of the countries originally funded under the President’s Plan for Emergency AIDS Relief (PEPFAR), in 2005 India became one of more than 120 countries funded under this program. PEPFAR programming purports to support a balanced ABC (abstinence, being faithful, and condom use) approach to AIDS prevention. As of 2006, however, PEPFAR has mandated that all countries receiving funding spend at least 1/3 of all prevention dollars on promoting the abstinence-until-marriage and be-faithful (AB) message. A recent Government Accounting Office report found that PEPFAR’s disproportionate focus on AB programming is hindering implementation of comprehensive prevention and, in many instances, is resulting in the exclusion of any prevention programming focused on correct and consistent condom use.⁴ Additionally, PEPFARs concentration on abstinence-until-marriage prevention messages does not take into account the sexual health needs of those, who for varied legal, cultural or economic reasons, cannot or choose not to marry.

Indian experts have been critical of PEPFAR’s disproportionate approach and have said that the AB prevention strategy ignores the reality of what is needed to combat an epidemic where 86% of HIV cases have been contracted through sexual intercourse.⁵ India’s new condom promotion campaign will not be funded with PEPFAR funds. Instead, the government is looking at alternative sources of funding and has proposed joining France and other countries in imposing an airline ticket tax to fund condom promotion and other prevention and treatment programs not currently paid for under foreign aid.⁶

For more information about this and other HIV/AIDS prevention programming in India, see:

The Kaiser Family Foundation’s Global Health Reporting

For more information about PEPFAR and the abstinence only-until- marriage funding requirement, see “Global Health: Spending Requirement Presents Challenges for Allocating Prevention Funding Under the President’s Emergency Plan for AIDS Relief,” Government Accounting Office, 04 April 2006, accessed 29 September 2006, < http://www.gao.gov/new.items/d06395.pdf >

References