The Right Way to Fight AIDS

Each year, young people between the ages of 10 and 24 years old, account for half of new HIV cases—7,000 contract HIV each day. As freshmen at Columbia, the RA door’s stash of condoms is one element of life in the halls of Carman or John Jay.My RA had a sign that said, “Take what you need—not what you think you’ll need!” This message indicates precisely what we take for granted that, by now, our leaders, doctors, and teachers have taught us well enough so that we can make our own (hopefully good) decisions about sexual behavior and our sexual health.

You may or may not be familiar with PEPFAR (the President’s Emergency Plan for AIDS Relief) and its action model, A-B-C, which stands for Abstinence, Be Faithful, Correct and Consistent use of Condoms. In the 15 PEPFAR focus countries, and in the other 100 countries that receive PEPFAR grants, information and provision of condoms is only allowed for people who practice high-risk behaviors—which only include “prostitutes, sexually active discordant couples—in which one partner is known to have HIV—substance abusers, and others”.

Condoms are not mentioned as a strategy for HIV prevention among the generalized youth. In fact, there is a requirement that 1/3 of PEPFAR funds are spent on abstinence-until-marriage programs. One of the biggest problems with the current ABC model is that 80% of women who contract HIV are infected by their husbands or primary partners.

Clearly, abstinence-until-marriage is ineffective when the majority of women who are newly infected are married. Any federally funded program must acknowledge that, unfortunately, in many parts of the world, the single greatest risk-factor for a woman to contract HIV is marriage—rates of infidelity are high and many women have little control negotiating safe sex with primary partners. Instead of avoiding discussion about condoms, programs need to focus on how condoms can be successfully introduced within the context of marriage and other regular sexual relationships. About half of new HIV infections occur in youth between the ages of 15-24, showing that too many youth are already sexually active to preach abstinence to them.

Withholding vital information from sexually active people is not going to make them abstain; rather, it means when they do have sex, they’ll be much less likely to know how to protect themselves. Studies have shown that comprehensive sex education, not abstinence-only, is more likely to result in delayed sexual debut and safer sex practices.

There is plenty of work to be done on other critical issues concerning HIV/AIDS, such as gender, racial, economic and educational inequality, as well as discourse that is subject to heteronormativity and sex negativity. In the meantime, there are two pieces of legislation that college students and sexually active individuals all over the country should work to support. We should support them because it is imperative that people, especially youth, around the world are exposed to the same basic sexual health information as those growing up in rich countries like this one.

One of the most significant limitations on the PEPFAR model is the stipulated ‘one-third’ earmark, whereby one third of the HIV prevention funding given to other by the United States must be spent on abstinence-until-marriage education programs. The PATHWAY (Protection Against Transmission of HIV for Women and Youth) Act of 2007 ( H.R. 1718) would remove this ‘one third’ funding earmark, as well as implement a comprehensive platform for prevention of HIV among women and girls by increasing access to condoms and more training on safer sex.

At the moment, there are 92 co-sponsors of this bill. There is a corresponding bill in the Senate called the HIV Prevention Act ( S.1553.IS). It is crucial to the success of both of these bills­­—and the lives of millions of people—that more members of Congress sign on.

The author, the president of Global Justice, is a Columbia College senior majoring in history. For world AIDS day, the College Dems, Global Justice, and Model UN will have a table on the Steps on Wednesday from 11-2.