Adrienne Germain

WASHINGTON, D.C. (WOMENSENEWS)–The March-through-May debate on international HIV-AIDS funding gave conservative “family values” groups an opportunity for muscle-flexing. The bill that resulted mandates that a third of the funds go to abstinence before marriage programs.

The bill was passed by House and the Senate and Bush is expected to quickly sign it into law.

The result, some public-health advocatesfear, could limit the ability of the generous funding to curb the pandemic in Africa, where AIDS has killed more than 30 million people in the past two decades. International health experts believe another 50 million could die by 2010 if the pandemic is not curbed. More women than men now have HIV-AIDS.

In a telephone interview, Adrienne Germain, president of the International Women’s Health Coalition, a nonprofit group based in New York, lamented the ideological amendments by conservatives, “which could actually set back some small progress we had been making to contain this epidemic.” She added, “There is no evidence that abstinence alone does the job. Most African women who have AIDS are monogamous and married. Their only risk factor is the behavior of their husbands. So marriage only won’t do anything to affect this.”

Bush’s State-of-the-Union Announcement Was a Surprise

President George W. Bush surprised many in January when, during his State of the Union address, he committed to spending billions of dollars to combat AIDS in Africa. Up to that point, neither the White House nor Bush’s conservative backers had shown much interest in the AIDS pandemic.

Last year, however, others on Capitol Hill were working on the problem. John Kerry, the Democratic senator from Massachusetts, along with Republican Senator Bill Frist of Tennessee, won Senate passage of an AIDS bill. Conservative heavyweight Representative Henry Hyde, a Republican from Illinois, pushed another HIV-AIDS bill through the House. Although the amounts of money in each bill differed, both were aimed at curbing the African pandemic. At the end of the year, time ran out on reconciling the two bills, requiring new starts with the current Congress.

This year, with Kerry running for president, Bush took the initiative by throwing the White House behind a $15 billion HIV-AIDS program aimed at the 14 countries where AIDS is out of control. By then, Frist, a surgeon who also is a close ally of Bush, had become Senate majority leader. He had seen the AIDS crisis first-hand during trips to Africa with teams of doctors. With Hyde and Frist on board, it appeared that Bush’s proposal might sail through with minimal controversy.


After largely ignoring the Hyde and Kerry hearings last year, conservative “family values” groups, most with headquarters in Washington, D.C.–such as the Family Research Council, Eagle Forum and Concerned Women of America–went into high gear this spring to insert some of their key beliefs into the legislation authorizing a five-year, $15 billion HIV-AIDS program in 14 countries (12 in Africa, two in the Caribbean). Predictably, much of the dust-up was about sex, condoms and abstinence.

One goal was to curb the use of condoms. Those are permitted, specifically, in the HIV-AIDS bill–but the family-values lobbyists won approval to require that 33 percent of the money slated for prevention to be used for “abstinence-until-marriage” programs. This came through an amendment added to the House bill by Joseph R. Pitts, a Republican from Pennsylvania, on a 220-197 vote May 1.

Representative Christopher Smith, a Republican from New Jersey, added a “conscience clause” to the bill that will let faith-based groups landing AIDS contracts for Africa to opt out of promoting condom use if this violates their religious beliefs. (Catholic relief services care for nearly one-fourth of the AIDS victims in Africa.)

Frist Pushed Through House Version

Frist accepted the House bill, intact, taking a “like it or lump it” approach that no changes would be allowed in the Senate. He made approval of the House bill, including the conscience clause and the mandated “abstinence” money, a party-line issue, in the rush to get a bill to Bush to sign before the European summit of world leaders in the first week of June. During the debate, Dianne Feinstein, the Democratic senator from California, attempted and failed by a 45-52 vote to eliminate the abstinence mandate.

Some conservatives applauded.

One was Ken Connor, president of the Family Research Council, a nonprofit conservative group based in Washington, D.C. He posted a brag-note on the organization’s Web site on May 19, saying “our groups worked tirelessly over the past three months to fix a bad bill and ensure that the final legislation reflected sound pro-family principles.” He applauded Frist, Pitts, Smith and Hyde for ensuring that the bill “included a designated emphasis on promoting abstinence and faithfulness in marriage. This emphasis discombobulated Sen. Dianne Feinstein, whose amendment calling for a condom airlift was defeated.” Connor said the Family Research Council agrees with Feinstein’s focus on prevention, but said she “cannot seem to grasp that abstinence is the only 100 percent effective prevention.”

Uganda Experience Debated

Conservatives pushing the abstinence-only approach say this worked in Uganda, which has cut its AIDS infection rate from 15 percent to 5 percent of the population since 1991.

That distorts the reality, says Sophia Mukasa Monico, former director of Uganda’s primary AIDS assistance group. Monico, now in Washington, D.C. and a staff member of the Global Health Council, an international membership group with offices in Washington and White River Junction, Vt., says abstinence was a small part of their tool kit under the “ABC” campaign from the World Health Organization, which says, in effect, abstain; if you can’t, then be faithful; if you can’t do that, use a condom.

Susan Cohen, director of government affairs for The Alan Guttmacher Institute, says the tide turned in Uganda due to strong political leadership from President Yoweri Museveni, who called fighting AIDS a “patriotic duty.” The Guttmacher Institute is a nonprofit group doing research on sexual and reproductive health and related policy and educational issues, with offices in D.C. and New York.

The HIV-AIDS bill does include one surprising initiative offered by Representative Joseph Crowley, a Democrat from New York. The conservatives also backed its requirement that some of the $15 billion be used for programs “targeted to men and boys emphasizing gender equality and respect for women and girls.”

International Women’s Health Coalition’s Germain says, “The Crowley amendment is really important, to encourage men to be responsible in their sexual behavior, to reduce sexual coercion, to reduce child marriage and polygamy, to reduce ‘widow inheritance’–all of which make women vulnerable.”

Peggy Simpson, a veteran public affairs reporter, recently returned to Washington after a decade in Central-Eastern Europe.

For more information:

International Women’s Health Coalition:

Also see Women’s eNews, May 20, 2002:
“U.S. Tells Teen Girls Worldwide to Just Say No”:

Also see Women’s eNews, January 20, 2003
“Bush’s Anti-Choice Policies Felt Around World”: