Abstinence-only education sounds reasonable, but it puts Africans at risk.

On May 27, President Bush signed the Global AIDS Act into law, fulfilling a promise he made during his State of the Union address to help combat AIDS in Africa. In October, the U.S. Senate helped honor that pledge by allocating desperately needed funds for the legislation.

While we congratulate Congress for its commitment to reducing the incidence of HIV/AIDS, we are seriously alarmed by certain provisions, which emphasize an ideology over sound medical practice. Specifically, the language of the Global AIDS Act requires that one-third of all HIV/AIDS prevention funds be set aside for abstinence-only-until-marriage programs.

On the surface, abstinence-only education may sound reasonable, but the reality is quite different. Law strictly defines these programs. There can be no discussion of contraception aside from failure rates. This censorship applies to all regardless of sexual activity or requests for information about contraception. Programs must adhere to eight points including: “sexual activity outside of the context of marriage is likely to have harmful psychological and physical effects; and bearing children out-of-wedlock is likely to have harmful consequences for the child, the child’s parents and society.”

Abstinence-only programs were first introduced as a part of the 1996 welfare reform and, subsequently, Congress has allocated well over a half a billion dollars for these programs, even though there is no credible evidence that they reduce sexual activity or risk-taking behaviors. In fact, there is significant potential harm done by focusing prevention efforts only on abstinence.

Domestically, such programs have been shown to decrease the use of contraceptives. By allowing politics to increase the risk of HIV infection by discouraging contraception, the United States’ policy is contrary to the great promise of this bill in fighting the HIV/AIDS pandemic.

It is difficult to express the frustration of those who work to reduce the transmission of HIV/AIDS when we learned of the details in the Global AIDS Act and the dedication of such a large proportion of the prevention funds to abstinence-only programs.

It is one thing to force these programs upon our own citizens, but to export them to Third World nations ravaged by AIDS is quite another.

Stemming the AIDS pandemic requires multiple strategies including: behavior change programs, testing and treatment of sexually transmitted diseases, promoting voluntary counseling, harm reduction for IV drug users, preventing mother to child transmission, increasing blood safety, controlling infection in health care settings and devising programs geared towards people living with HIV/AIDS.

It is inappropriate to put funding for HIV/AIDS programs at the mercy of conservative ideology. More than 6,000 Africans die each day of AIDS; we cannot afford to spend money on programs that simply do not work.

Recognizing this shortcoming, Sen. Olympia Snowe along with Sen. Dianne Feinstein proposed an amendment to restrict the amount of HIV/AIDS prevention funds devoted to abstinence-only programs. Rather than mandate that one-third of all prevention programs adopt abstinence-only approaches, this amendment would ensure that only programs dedicated to the reduction of the sexual transmission of HIV be subject to the mandate. Granted, this still leaves a considerable amount of funds allocated to unproven programs, but clearly the alternative is worse.

The Feinstein/Snowe Amendment would encourage the development of programs that take into account country needs, including cultural differences, epidemiology, population age groups, the stage of the epidemic and changes over time. It refutes the ideology that HIV transmission is a result of consensual sexual activity between a man and woman and can simply be stemmed by abstinence.

Unfortunately, this amendment failed by a 45-47 margin. Both Maine Senators supported the measure. This news is troubling as it marks another victory for ideology over medically proven prevention programs.

This censorship is dangerous and potentially life threatening. Uganda, one of the few success stories in Africa, engaged in a massive public education campaign modeled on the “ABC” approach: abstinence, be faithful, use condoms. This approach helped drop the country’s HIV infection rate to about six percent from its high of about 30 percent.

Uganda has invested heavily in training health workers, creating counseling networks, treating sexually transmitted diseases, expanding HIV testing and educating the country about HIV/AIDS prevention. Yet, this approach could not be applied under the abstinence-only provision as it discusses condoms and how to use them.

The circumstances in Africa are dire and something must be done. Yet, the solution before us is not adequate and potential harm is being inflicted. We need to pass legislation designed to save lives, not further a conservative agenda.

George A. Hill is the executive director of the Family Planning Association of Maine and Julia McDonald is the executive director of the Maine AIDS Alliance.