‘Be true’ needs redo

There’s no evidence that promoting abstinence and fidelity changes sexual behavior, according to a Stanford analysis of U.S.-funded HIV-​prevention programs around the world.

Since 2004, the President’s Emergency Plan for AIDS Relief has allocated $1.4 billion to abstinence and “be faithful” programs. The researchers found no statistically significant differences between PEPFAR and non-PEPFAR countries in the number of annual sexual partners per person, age of first intercourse or rate of teen pregnancy.

“Changing sexual behavior is not an easy thing,” says senior author Eran Bendavid, MD, assistant professor of medicine. “When individuals make decisions about sex, they are not typically thinking about the billboard they may have seen.” He points out that the abstinence-fidelity programs divert funds from evidence-based methods of reducing HIV risk that could save lives.

Nathan Lo, an MD/PhD student, is the lead author of the study, which appeared in the May 2016 issue of Health Affairs.