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 When researchers looked at the number of sexual partners in the past
year, age at first sexual intercourse and teenage pregnancy, there
were no differences between countries that did or did not receive
the funding.
"Changing HIV risk behaviors is hard to do, and the limited
resources available for HIV prevention should be used carefully and
directed towards programs that are likely to be effective," said
senior author Dr. Eran Bendavid, of the Stanford University School
of Medicine in California.
The U.S. President's Emergency Plan for AIDS Relief (PEPFAR) defines
the components of its "ABC approach" as abstinence, be faithful and
correct and consistent condom use.
Generally, the results of abstinence and faithfulness education
programs are mixed, the researchers write in Health Affairs. Also,
the effectiveness of these campaigns in sub-Saharan Africa remain
unknown. In that part of the world, there were nearly 26 million
people living with HIV in 2014, according to the World Health
Organization. The region accounts for about 70 percent of new HIV
infections around the globe.
Yet, PEPFAR invested more than $1.4 billion in abstinence and
faithfulness programs between 2004 and 2013.
For the new study, the researchers looked at whether abstinence and
faithfulness program funding was tied to changes in high-risk sexual
behaviors among 477,694 people under age 30 in 22 sub-Saharan
African countries between 1998 and 2013 - including 14 countries
that received PEPFAR funding.
The funding did not seem to affect the number of sexual partners in
the past year, age at first sexual intercourse or rates of teenage
pregnancy.
U.S. studies too have found no or minimal effects of abstinence
education on high-risk sexual behaviors and HIV incidence, the
researchers say.
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In a statement emailed to Reuters Health, a PEPFAR spokesperson said
the initiative's approach and investments have continuously evolved
based on scientific evidence.
"Current prevention science demonstrates that a combination package
of evidence-based behavioral, biomedical, and structural prevention
interventions, tailored to the populations and geographic areas with
the greatest burden, is most effective in addressing the epidemic,"
said the spokesperson.
Bendavid said in an email that solid evidence supports adult male
circumcision, antiretroviral therapy, prevention of mother-to-child
transmission and pre-exposure prophylaxis for HIV prevention.
"These are all evidence-based alternative preventive methods," he
said.
The researchers say investing in evidence-backed programs could lead
to improvements across the population.
SOURCE: http://bit.ly/26Qty5C Health Affairs, online May 2, 2016.
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