Abstinence, fidelity programs ineffective at preventing AIDS, study finds

Researchers at Stanford University suggest nearly $1.4 billion has been wasted on efforts that have not affected the spread of HIV and AIDS.

By Stephen Feller

WASHINGTON, May 3 (UPI) -- Although abstaining from sex and being faithful in marriage theoretically have the potential to reduce HIV and AIDS transmission, the reality is promotion of either has no effect on people's behavior or reducing risk, according to new research.

Researchers at Stanford University found no evidence educational programs sponsored by the U.S. government in 22 countries have affected the spread of HIV or AIDS, suggesting the tens of millions of dollars spent on them have better uses.


Since 2004, when President George W. Bush established the President's Emergency Fund for AIDS Relief, or PEPFAR, $33.3 billion has been budgeted for antiretroviral therapy, HIV testing, counseling and other programs to promote prevention, care and treatment around the world. Of this, $1.4 billion has been spent on programs specifically aimed at abstinence and marital fidelity education.

Researchers at the University of California Los Angeles found in a separate study that overall funding for the program has declined since it's start, and Stanford researchers found funding for abstinence and marital programs also has declined significantly since 2009 when President Barack Obama came into office, dropping from $260 million in 2008 to $45 million in 2013.


While money already spent is gone, the researchers say more than $50 million per year could be better spent on programs that actually work -- and the controversial behavioral programs are not among them.

"Changing sexual behavior is not an easy thing," Dr. Eran Bendavid, an assistant professor of medicine at Stanford University, said in a press release. "These are very personal decisions. When individuals make decisions about sex, they are not typically thinking about the billboard they may have seen or the guy who came by the village and said they should wait until marriage. Behavioral change is much more complicated than that."

For the study, published in the journal Health Affairs, the researchers analyzed survey information on 500,000 people in 22 countries between 1998 and 2013.

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Among 345,000 women and 132,000 men, the researchers found no difference in the number of sexual partners people had between areas PEPFAR programs were in place and those with no PEPFAR programs.

PEPFAR programs delayed the first sexual intercourse among 178,000 women by about four months, considered a slight difference, and no difference was found for 71,000 men in the study, researchers report. The number of teen pregnancies among 27,000 women also was found to be unaffected by the educational programs.


"Overall we were not able to detect any population-level benefit from this program," said Nathan Lo, a doctoral student at Stanford University. "We did not detect any effect of PEPFAR funding on the number of sexual partners or upon the age of sexual intercourse. And we did not detect any effect on the proportion of teen pregnancy. We believe funding should be considered for programs that have a stronger evidence basis."

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