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The Facts
Protection Against Transmission of HIV for Women and Youth Act of 2007
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The Protection Against Transmission of HIV for Women and Youth (PATHWAY) Act of 2007 (H.R. 1713) calls for the development of a comprehensive HIV prevention strategy that incorporates the specific needs of women and girls, and especially addresses the factors that lead to gender disparities in developing countries. The PATHWAY Act also calls for the repeal of the congressional earmark in the President’s Emergency Plan for AIDS Relief (PEPFAR) that requires that at least 33% of HIV prevention funding be used exclusively for programs that teach abstinence-until-marriage.[1]
The PATHWAY Act was first introduced in the 109th Congress and had 86 co-sponsors. The bill was re-introduced on March 27, 2007 by Congresswoman Barbara Lee (D-CA) and Congressman Chris Shays (R-CT).
Background
It is estimated that over 38.6 million people worldwide are currently living with HIV/AIDS. Unprotected sexual contact between heterosexual partners represents 80 percent of new infections in Sub-Saharan Africa. In the same region, women and girls account for 60 percent of all infections, and 76 percent of infected women are between the ages of 15-24.[2]
PEPFAR’s HIV prevention strategy ignores the realities of young people’s lives and does not adequately focus on the gender disparities in the HIV pandemic for women and girls. Moreover, the earmark requiring that 33 percent of prevention funds be used for abstinence-until-marriage programs severely hinders program effectiveness.
Why is the PATHWAY Act Needed?
Women and girls are biologically, socially, and economically more vulnerable to HIV infection than men. Young women are 1.6 times more likely to be living with HIV/AIDS than young men worldwide, while Sub-Saharan African women aged 15-24 are now three times more likely to be infected with HIV than their male counterparts.[2]
Women and girls are more vulnerable to HIV than their male counterparts for a variety of reasons that often can be traced to the second-class treatment of women. These reasons include:
- Cross-generational sex with older men and early/child marriage;
- High rates of infection within marriage, compounded by an inability to negotiate safer sex practices;
- Lack of educational and employment opportunities;
- High rates of gender-based violence, rape, and sexual coercion;
- An increase in reliance on commercial sex for income;
- Lack of basic HIV prevention information and services, as well as lack of access to female-controlled prevention methods;
- High rates of other sexually transmitted diseases and unintended pregnancies;
- Overall lack of legal protection of the rights of women and girls.[2]
It is clear that policies and programs must do more to address gender disparities if the President wishes to meet his goal of preventing 7 million new infections.
The United States Government Accountability Office (GAO) recently conducted a review of how the Office of the Global AIDS Coordinator (OGAC) allocates its funding from PEPFAR. The report found the following impediments caused by the abstinence-until-marriage earmark:
- Unclear guidance about how to implement the segmented ABC (Abstinence, Be Faithful, Use Condoms) plan has caused widespread confusion among service-providers in PEPFAR countries.
- Separate abstinence-until-marriage requirements for youth “undermine” the integration of ABC programs. The majority of focus country teams responded that isolating AB programs from other programs compromised the prevention program as a whole.
- Meeting abstinence-until-marriage spending requirements impeded the response to prevention needs. Country teams indicated that the spending requirements hampered their ability to respond to local epidemiological and social norms, deliver comprehensive prevention messages to at-risk groups, fund medical and blood safety activities, and fund care programs. Indeed, half of the countries submitted requests for exemptions from the spending requirements to better fund other programs.
- Nonexempt countries suffer because of exemptions. Because ten countries received exemptions, the remaining ten were forced to spend more than 33% of their funding on abstinence-only programs, so that the overall spending for the 20 countries reflected the 33 percent requirement.
- OGAC overstepped the abstinence-until-marriage spending requirement. Even though the law requires that the abstinence-only spending limit be applied to the Global HIV/AIDS Initiative (GHAI) account, OGAC applied it to all PEPFAR spending. Therefore, country teams were prevented from allocating non-GHAI funds to address local needs if the allocations did not comply with the abstinence-until-marriage requirements.[3]
How would the PATHWAY act help?
The PATHWAY Act would require the President to develop a comprehensive HIV prevention plan that focuses on the needs of women and girls. Such a strategy would:
- Encourage women and girls to avoid cross-generational sex and discourage early/child marriage;
- Increase access to female-controlled prevention methods and training;
- Accelerate the de-stigmatization of HIV/AIDS;
- Combat gender-based violence and rape;
- Promote gender equity in male attitudes;
- Support job training and other programs to assist women in becoming economically independent;
- Expand educational opportunities for women and girls;
- Protect property and inheritance rights for women;
- Coordinate existing health and reproductive services with HIV prevention services;
- Support civil society organizations focused on the needs of women; and
- Create the legal framework that would guarantee equal rights and equal protection under the law.
The PATHWAY Act would also amend the United States Leadership Against HIV/AIDS, Tuberculosis and Malaria Act of 2003, repealing the earmark that requires that 33 percent of HIV prevention be used for abstinence-until-marriage programs.[1,4]
Support for the Protection Against Transmission of HIV for Women and Youth Act of 2006
More than 60 local, state, and national organizations support the Protection Against Transmission of HIV for Women and Youth (PATHWAY) Act, including medical, civil rights, faith-based, family planning, educational, public health, reproductive rights, and HIV and AIDS service organizations.
References
- United States House of Representatives. Protection Against Transmission of HIV for Women and Youth (PATHWAY) Act of 2006 (H.R. 5674), 109th Congress, 2nd Session, June 22, 2006.
- UNAIDS, UNFPA, UNIFEM. Women and HIV/AIDS: Confronting the Crisis. 2004; http://genderandaids.org/downloads/conference/308_filename_women_aids1.pdf . Accessed on July 26, 2006.
- United States Government Accountability Office. GLOBAL HEALTH: Spending Requirement Presents Challenges for Allocating Prevention Funding under the President’s Emergency Plan for AIDS Relief. [GAO-06-395] Washington, D.C.: The Office, 2006; p. 31
- United States House of Representatives. H.R. 1298. `United States Leadership Against HIV/AIDS, Tuberculosis, and Malaria Act of 2003'.
Written by Naina Dhingra and Chase Johnson, July 2006
Updated March 2007
© Advocates for Youth
More Information on the Pathway Act >>
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Press Release :: Bill Status on H.R. 1713 :: PDF File of H.R. 1713
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