ADVOCATES FOR YOUTH

Related Resources: >> Read the Author's Blog About the Report. >> The IOM Report on PEPFAR Implementation >>Improving U.S. Global HIV Prevention for Youth >> The GAO Report on PEPFAR Prevention Programs >> The PATHWAY ACT of 2007 >> Executive Summary: Science and Success in Developing Countries

Improving U.S. Global AIDS Policy for Young People: Assessing the President’s Emergency Plan for AIDS Relief (PEPFAR)

The Publication (46 pages)

The Executive Summary (7 pages)

• Read the Executive Summary [HTML] [PDF]
• Read the Publication [PDF]

Young people are critical to success of the President’s Emergency Plan for AIDS Relief (PEPFAR). Yet PEPFAR has, so far, largely ignored the realities of young people’s lives and the state of the epidemic among youth. U.S. government policies severely limit PEPFAR’s use of effective, science-based, public health responses to reducing HIV transmission among youth. Such policies include the ideological funding mandate by Congress to spend 33 percent of prevention dollars on abstinence-until-marriage programs as well as various guidance directives from the Office of Global AIDS Coordinator (OGAC).

"Improving U.S. Global AIDS Policy for Young People: Assessing the President’s Emergency Plan for AIDS Relief” identifies some of the severe limitations of these policies as well as how the policies contradict public health science. This report discusses three major shortcomings of PEPFAR in addressing HIV/AIDS and young people:

• Ideology has trumped science in PEPFAR’s HIV prevention strategy for young people.
• PEPFAR resists linking HIV prevention with reproductive health care and services.
• PEPFAR does not pay adequate attention to HIV-positive adolescents as a vulnerable population.

Congress, OGAC, and country teams have the power to greatly improve the situation for young people and to reform PEPFAR’s response to one that is science-based and respectful of youth’s rights to comprehensive HIV prevention that is linked with reproductive health services. Some of the key recommendations in the report include:

• Repeal the abstinence-until-marriage funding mandate in the U.S. Leadership Act.
• Consider IOM’s recommendation to remove all PEPFAR funding mandates or, at least, make all earmarks non-binding to allow country teams flexibility to meet local needs.
• Revise OGAC’s ABC Guidance to reflect evidence-based best practices for HIV prevention among youth.
• Increase appropriations for family planning through USAID’s Office of Population and Reproductive Health.
• Require OGAC to improve monitoring and evaluation of programs using more precise age data.
• Convene a technical working group on HIV–positive adolescents. From the lessons learned at the consultation, issue new guidance on HIV-positive youth’s needs.

PEPFAR’s congressional authorization will expire in fiscal year 2008. Advocates for Youth urges members of Congress and staff as well as OGAC, the Administration, and colleague organizations to consider seriously the recommendations in this report and to ensure that youth are not, once again, ignored by PEPFAR. Without serious reflection and change, current policies will hinder PEPFAR from attaining its laudable goals and will leave a generation defenseless against HIV/AIDS.