Abstinence promotion under PEPFAR: the shifting focus of HIV prevention for youth

Glob Public Health. 2013;8(1):1-12. doi: 10.1080/17441692.2012.759609. Epub 2013 Jan 18.


Abstinence-until-marriage (AUM) - strongly supported by religious conservatives in the USA - became a key element of initial human immunodeficiency virus (HIV) prevention efforts under the President's Emergency Plan for AIDS Relief (PEPFAR). AUM programmes have demonstrated limited efficacy in changing behaviours, promoted medically inaccurate information and withheld life-saving information about risk reduction. A focus on AUM also undermined national efforts in Africa to create integrated youth HIV prevention programmes. PEPFAR prevention efforts after 2008 shifted to science-based programming, however, vestiges of AUM remain. Primary prevention programmes within PEPFAR are essential and nations must be able to design HIV prevention based on local needs and prevention science.

Publication types

  • Research Support, N.I.H., Extramural
  • Review

MeSH terms

  • Adolescent
  • Adolescent Behavior*
  • Africa / epidemiology
  • Budgets
  • Condoms / standards
  • Condoms / trends
  • Evaluation Studies as Topic
  • Female
  • HIV Infections / economics
  • HIV Infections / epidemiology
  • HIV Infections / prevention & control*
  • HIV Infections / transmission
  • Humans
  • International Cooperation
  • Male
  • Religion and Sex*
  • Sex Education / methods
  • Sex Education / standards*
  • Sex Education / trends
  • Sexual Abstinence*
  • United States
  • Young Adult