When President Bush announced his five-year, $15 billion plan for AIDS relief, the administration endorsed the "ABC" approach: promoting Abstinence, Being faithful, and correct and consistent use of Condoms. The restrictions passed by Congress on this funding require that at least one-third of HIV prevention funds be spent on abstinence-until-marriage programs.

CARE strongly supports the president's goal of preventing the spread of HIV, and we believe that efforts to promote abstinence and faithfulness can be valuable. But our extensive experience in the field has shown that abstinence-until-marriage programs alone do not fully address the challenges that women in the developing world face in protecting themselves and their children from HIV infection. Consider the following examples:

• Mpolokeng, 38, lives in Lesotho in southern Africa. In 1984, she married her high school sweetheart. Her husband left to work as a miner in South Africa and was seldom home. He returned for good when he became too ill to work, and Mpolokeng took care of him. In 2005 her husband died, and Mpolokeng started to feel sick as well. She went to be tested and found out she was HIV-positive.
  
  
• Gatrude is a sex worker in Bughoye, Uganda. Every day she remains in the sex trade is another day she puts herself at risk of contracting HIV. She knows the risk, but she has no other options to put food on the table for her children. "It's not by choice I do this work," Gatrude says. "If I had an alternative, I would stop this work immediately."
  
  
• Fauster, a mother of two, lives in Rwanda. Her husband died when she was six months pregnant; people told her he died from AIDS, but she didn't understand, and thought he had been poisoned. Before she gave birth, she went in for pre-natal care and tested positive for HIV.

Would abstinence-until-marriage programs have helped these women? Would they help prevent Fauster's unborn child from contracting HIV?

The fact is that many women living in poverty are not in a position to refuse sex, or they are compelled to engage in sex for survival. Many others contract HIV in a relationship where they themselves are faithful but their partners are not. In some developing countries, married, monogamous women are more likely to contract HIV than women who are unmarried and sexually active. For some of these women, condoms may be the only source of protection.

For still others, the ABC approach may offer no protection at all. In communities where social, cultural and economic factors prevent women from choosing abstinence, demanding faithfulness from their partners or insisting on condom use, it can be difficult or impossible for women to protect themselves from HIV. Without access to lifesaving anti-retroviral drugs, women who are already infected cannot protect their unborn children from contracting the disease. If our HIV prevention efforts do not move beyond the simplistic ABC formula, we will lose the battle against AIDS.

CARE has over 100 HIV/AIDS projects in 39 countries, and we've seen firsthand how women and girls are disproportionately affected by the AIDS pandemic. We've also learned that the most effective way to reduce HIV transmission is by providing a range of strategies that address the realities women face in developing countries. Empowering women and girls to overcome their social and economic vulnerability must be a cornerstone of our response to AIDS. Education for young girls, economic empowerment, public health infrastructure, access to family planning services, protection from sexual violence and livelihood support for desperately poor people are the ultimate foundation on which an effective HIV prevention strategy must be built.

It's not too late to challenge the arbitrary restrictions that current policy places on U.S. funding for HIV prevention. CARE supports recent legislation introduced by Sens. Dianne Feinstein, D-Calif., and Olympia Snowe, R-Maine, to strengthen HIV prevention efforts by providing greater flexibility to organizations like CARE that confront the AIDS pandemic every day. Help us build momentum for this important initiative by asking your senators to co-sponsor the HIV Prevention for Youth Act today!

Take Action!

The current abstinence-only requirement stands in the way of a fully effective response to the AIDS pandemic. Urge Congress to strengthen HIV prevention efforts by removing arbitrary restrictions in how U.S. funds are spent.