This money was spent without any assessment of its effectiveness, and with a giant opportunity cost. Can you imagine if that much money had been moved to funding for girls in school, the single factor that best reduced HIV. Or female reproductive health. Or treatment. Instead, an ideological commitment by evangelicals to abstinence caused $1.4 BILLION dollars of AIDS money to be spent without any benefit.
Quote below via Catherine Gorman at SciAm’s Public Health blog:
Over the past 15 years the U.S. has spent $1.4 billion promoting abstinence before marriage as a way of preventing HIV in 14 countries in sub-Saharan Africa. Unfortunately, according to the most comprehensive, independent study conducted to date of the effort, the money was pretty much wasted. A rigorous comparison of national data from countries that received abstinence funding under the 2003 U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) with those that had not showed no difference in the age of first sexual experience, number of sexual partners or teenage pregnancies—all aspects of behaviors that have been linked to a higher risk of becoming infected with HIV…
So why did PEPFAR spend so much money on abstinence programs? That was Congress’s idea. Responding to pressure from religious conservatives, the legislature mandated in 2003 that at least a third of PEPFAR’s prevention budget be spent on telling people to refrain from sex before marriage. That specific requirement was dropped in the 2008 bill that reauthorized the program and PEPFAR has spent progressively less money on abstinence education over the intervening years. Still, the study’s authors point out, PEPFAR allocated $45 million to abstinence education in 2013. “There is a big opportunity cost there,” Lo says. “It’s not necessarily a benign expenditure.” [link]