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U.S. Officials Travel to Africa Bearing the Anti-Sexual Health Message of U.S. Foreign Policy

U.S. Representative Christopher Smith (R-NJ) and First Lady Laura Bush both traveled to Africa this winter, visiting key countries receiving funds under the President’s Emergency Plan for AIDS Relief (PEPFAR). While Smith promoted his opposition to abortion rights for women, the First Lady defended the U.S. focus on abstinence promotion as HIV prevention, claiming that women need to hear messages about abstinence.

Smith capitalized on the winter recess to travel to Uganda , the country at the heart of the international debate over HIV-prevention education. Smith, who is the former head of New Jersey Right to Life, met with Ugandan President Yoweri Museveni and toured different parts of Uganda “to create awareness on the danger pertaining to abortion.”1

In her recent African tour, which included visits to U.S.-funded HIV/AIDS projects in Ghana and Nigeria, First Lady Laura Bush claimed that PEPFAR’s prevention paradigm “has been Uganda’s plan which is the abstinence, be faithful and the correct and consistent use of condoms (ABC) approach.” Under PEPFAR, however, not everyone is eligible to receive the full ABC message. PEPFAR only funds condom programming for groups of people deemed “high risk” by the Administration, and this excludes young people and adults generally, even though HIV-prevalence rates in some communities are as high as 40%. Nevertheless, the First Lady called the U.S. global HIV-prevention effort “a very fair divide.” She continued, “I’m always a little bit irritated when I hear the criticism of abstinence, because abstinence is absolutely 100 per cent effective in eradicating a sexually transmitted disease. In many countries where girls feel obligated to comply with the wishes of men, girls need to know that abstinence is a choice.”2

In fact, in many countries, social norms and economic dependence on men make it difficult if not impossible for many women to tell their partners, including husbands, that they want to abstain from sex or use a condom. Similarly, poor women—single or with a partner—may have no source of income other than selling sex for money or goods. The current Administration claims to be promoting a prevention campaign of ABC but actually pressures programs into promoting abstinence-only for young people. This version of ABC is better described as “Asks the Impossible, Blames Women, and Costs Lives,” according to the International Community of Women Living with AIDS. The group proposes a new ‘ABC’ campaign to meet the real needs of women, “Assert Yourself, Be Open, Communicate!”3

“Of course, there is no one out there criticizing abstinence per se,” said William Smith , vice president for public policy at SIECUS. “The problem is with creating a policy and funding stream that supports programs that talk about abstinence and abstinence alone. Denying young people information about condoms— or worse—telling them they don’t work, abandons sexually active young people. No one should be exposed to HIV out of ignorance, because they are having sex at an age or in a type of relationship deemed inappropriate by administrators in Washington .”


  1. The State House of the Republic of Uganda, “President meets US Congressman Smith,” Press Release published 6 January 2006, accessed 23 January 2006, <>.
  2. “Laura Bush Calls U.S. Global HIV-Prevention Effort ‘Very Fair Divide’ Among Abstinence, Faithfulness, Condoms,” Kaiser Daily HIV Report , 17 January 2006, accessed 23 January 2006, <>.
  3. The International Community of Women Living with HIV/AIDS, “8 REASONS WHY ABC DOES NOT WORK!– HIV positive women explain why the ABC approach to HIV prevention and sexual and reproductive health for all women does not work,” accessed 30 January 2005, <>.