PEPFAR-funded abstinence work had no impact

Image from the presentation by Nathan Lo, at CROI 2015.

Image from the presentation by Nathan Lo, at CROI 2015.

Story via NAM (@aidsmap)


NAM is an award-winning, community-based organisation, which works from the UK. They deliver reliable and accurate HIV information across the world to HIV-positive people and to the professionals who treat, support and care for them.

Nearly US$1.3 billion spent on US-funded programmes to promote abstinence and faithfulness had no significant impact on behaviour in 14 countries in sub-Saharan Africa, a preliminary analysis of sexual behaviour data has shown.

The President’s Emergency Plan for AIDS Relief (PEPFAR) was launched in 2004 with a Congressional requirement for a fixed proportion of PEPFAR prevention funds to be spent on programmes promoting abstinence from sexual relations, delaying sexual activity and faithfulness to one partner. Programmes supported by this funding stream also promoted partner reduction. But while there may be epidemiological grounds for thinking that delaying sexual debut and reducing sexual activity might reduce opportunities for acquiring HIV, especially in young women, there is limited evidence for interventions that are effective in achieving these objectives.

The researchers compared trends in sexual behaviour derived from national Demographic and Health Surveys in 14 PEPFAR focus countries and eight other African countries where PEPFAR funding was not determining the content of HIV prevention interventions.

While there was a trend for men to have fewer sexual partners in both sets of countries, the researchers could not identify any impact associated with PEPFAR funding. Higher levels of PEPFAR funding in specific countries didn’t seem to be associated with differences in sexual behaviour either.

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