Study: Abstinence Education Does Little to Prevent HIV/AIDS

Since 2003, the United States has devoted nearly $1.5 billion toward abstinence programs in Africa, aiming to halt the spread of HIV worldwide. The program was funded as part of a larger initiative — the President’s Emergency Plan for AIDS Relief, or PEPFAR — that targets regions deemed most susceptible to the disease.

PEPFAR, with funding from the U.S. government, has doled out more than $52 billion to fight the epidemic that debilitates nearly 40 million people worldwide. Most of the funding went toward medicine, testing and counseling. But a portion of the funds were allocated toward so-called preventative measures, like advertising that encourages Africans to wait until marriage to have sexual intercourse.

Health officials rave about the number of people receiving treatment. PEPFAR’s most recent annual report revealed the program tested and counseled more than 68.2 million people in 2015 alone. It’s also credited with supporting “life-saving antiretrovial treatment” for more than 9.5 million people.

And while PEPFAR as a whole appears to be a successful program agreed upon by both Republicans and Democrats in Congress, its abstinence funding may have been misguided.

Earlier this year, researchers from Stanford compared HIV/AIDS trends in 22 sub-Saharan African countries. Their research, published in the journal Health Affairs, found no association between PEPFAR funding for abstinence and faithfulness and a significant change in "high-risk sexual behavior.”

The researchers analyzed surveys collected from nearly 500,000 people who were asked a range of questions from “How many sexual partners do you have?” to “At what age did you first have sex?” Fourteen of the countries studied received PEPFAR funding, while the remaining eight did not. They found that the countries receiving abstinence funding through PEPFAR did not adopt lower-risk behaviors any faster than those without such funding. 

Although the more than $1.4 billion devoted to abstinence training doesn’t represent a big chunk of the $52 billion set aside to combat HIV/AIDS, the study suggests it would be wise to find alternative funding priorities in order to “yield greater health benefits.”

That $1.4 billion was spent on sex education classes in schools and for public health advertisements on billboards and the radio. Funding for the abstinence program has been on the decline in recent years following its peak spending in 2008, when PEPFAR was rationing $250 million toward the program. In 2013, the funding of the abstinence and faithfulness program dropped to just $40 million.

NPR asked the agency whether or not the study would lower the funding even more. PEPFAR noted that the organization has a live platform and has adjusted its mission statement based on scientific studies and data before.

Image credit: Terrie Schweitzer/Flickr