When it comes to sex education, the abstinence-only approach has proven time and again to be ineffective at staving off teen pregnancy and the spread of disease. But that hasn’t stopped developed nations, such as the United States, as well as developing nations from teaching it. And while President Obama may have officially revoked federal funding for abstinence-only sex ed in February of this year, it lives on via American-funded aid programs overseas, where more traditional gender roles and ideas about sex and sexuality still reign.
In Uganda, preaching abstinence as part of HIV prevention is not only condoned—it's backed by the United States Agency for International Development (USAID), as part of the President's Emergency Plan For AIDS Relief (PEPFAR/Emergency Plan). And a series of posters shared on Twitter this week seem poised to do more harm than good.
The posters are aimed at young Ugandans who are embarking on their sexual journey, according to the campaign. Various versions contain abstinence-related code words or phrases, followed by “That’s my way of stopping HIV. What about you?” In one, a young man declares “I’m proud to be a virgin.” while another shows a woman saying “I’m faithful to my man.” Another features a woman coming right out and saying “I’m abstaining.” According to USAID, these posters aren’t the product of an unfortunate oversight. In fact, they’re completely in line with the agency's overall “approach to infuse [these messages] throughout prevention programs.”
In an email Thursday, Molly Lynn Westrate, a USAID press officer, told me:
These posters are consistent with PEPFAR's 'ABC Approach,' which employs population-specific interventions that emphasize abstinence for youth and other unmarried persons, including delay of sexual debut; mutual faithfulness and partner reduction for sexually active adults; and correct and consistent use of condoms by those whose behavior places them at risk for transmitting or becoming infected with HIV.
The ABC Approach she refers to stands for "abstinence, be faithful, and correct and consistent condom use." While one of the posters I found does show a man exclaiming “I’m in charge with condoms!” the prevailing message is that Ugandans should have sex with only one partner, or not at all.
When I first spoke to Westrate via phone earlier in the day and explained how the posters heavily promoted abstinence, she disagreed, noting that the “I’m faithful to my man” poster is “not promoting abstinence. It’s promoting not cheating on your boyfriend.”
The only problem with this hyper-conservative approach to HIV prevention is that it’s been expressly proven not to have worked in Uganda.
The 1990s saw an encouraging drop in the spread of HIV thanks to foreign aid and public health programs. But the results of the 2012 Uganda AIDS Indicator Survey, which interviewed 20,000 Ugandans, found that the HIV rate had risen to 7.3% from 6.4% in 2005, according to a New York Times story right after the survey release.
This unsettling increase in HIV came after PEPFAR spent $1.7 billion to fight AIDS in the region, and employed campaigns like "Get Off the Sexual Network," encouraging Ugandans to abstain and stick with one partner via billboards, radio ads, and video (seen below).
Ironically, some Christian missionaries—of which there are many in Uganda—don’t feel this campaign is conservative enough. A blog post from a religious organization called the Global Life Campaign includes images of two of the posters, and commentary griping about the message the posters send:
A leader we met with said it is very difficult to convince young people to be sexually pure and abstinent in the face of heavy promotion of condoms and contraception.
The U.S. Agency for International Development (USAID) widely promotes condoms in Uganda, especially around the capital city of Kampala, including near the entrances of Makerere University, the largest university in East Africa, with over 40,000 students. The rare “I’m faithful to my man” poster attempts to tie into the Uganda “Be faithful” in marriage campaign, but implies one man at a time outside of marriage.
This prominet (sic) American presence in the capital city of Uganda, undermining their national AB program (Abstinence before marriage, and Be faithful within marriage), was disturbing to me. Fr. Opio observed that these displays are not from the Uganda Government, but what the U.S. Government thinks Uganda needs.
While this analysis feels like a complete misreading of the cornerstones of USAID’s mission, it does show the existence of a comprehension gap. A young person interested in having sex for the first time could have a number of interpretations of the posters, and internalize some dangerous conclusions about safe sex and HIV prevention.
"The ABC approach is distinctive in its targeting of specific populations, the circumstances they face, and behaviors within those populations for change," USAID's Westrate said. "This targeted approach results in a comprehensive and effective prevention strategy that helps individuals personalize risk and develop tools to avoid risky behaviors under their control."
But as we've seen in the U.S., the most risky behavior of all is teaching young people abstinence. It seems high time to abstain from this message.
Marisa Kabas is a Sex + Life reporter based in New York City. She loves baseball, bunnies and bagels.