Alongside Abstinence, Give Youngsters Something to Do - AIDS Campaigners

By Stephen Mbogo | July 7, 2008 | 8:15 PM EDT

Nairobi, Kenya ( - A Kenyan anti-AIDS organization has welcomed a new U.S. initiative prompting abstinence as the best means to combat the epidemic in East Africa and the Caribbean -- but it says the measure should be accompanied by funding to help younger people find something constructive to do.

The best way to ensure that teenagers and young adults abstain from sex is "to facilitate their engagement in productive activities" which will both occupy them and enable them to earn a living, Poverty Alleviation Initiatives for Development coordinator Caroline Nyambura said here Thursday.

Nyambura's organization runs an anti-AIDS program targeting disadvantaged youths in Nairobi.

High unemployment rates for young people in Africa are believed to contribute to the rising HIV/AIDS infection rate. Many young people try to earn a living through commercial sex activity.

Nyambura said promoting abstinence was a good idea, but should be done in conjunction with programs encouraging youngsters to keep busy and be empowered economically, through manufacturing, small-scale food farming, and "micro-enterprises."

The U.S. Agency for International Development (USAID) recently announced it will provide $17 million in grants to initiate sex-abstinence campaigns in Kenya, Rwanda, Tanzania, Mozambique and Haiti.

The focus on abstinence arises from a successful campaign in Uganda, where HIV infection rates were brought down from 30 per cent in early 1990s to below 10 per cent today.

Uganda's "True Love Waits" abstinence-until-marriage program, launched in 1994 and supported by schools and religious organizations, is credited with bringing down the infection rate.

Abstinence was part of a three-pronged strategy nicknamed ABC - Abstinence, Be faithful (stick to one sexual partner) and Condom use.

James Oduor, a consultant on AIDS counseling and prevention, said the campaign here should aim to lift the age of "sexual introduction" from the current 12-18 years, to 21 years and older.

Those in the slightly older group should be encouraged to abstain from sex through education about AIDS. Members of that older age group should also be encouraged to use condoms and to visit voluntary counselling and testing centres, he said.

The U.S.-funded programs will be spearheaded by World Relief in East Africa and by the American Red Cross in the Caribbean. They aim to targets at least two million youths and 200,000 adults.

The grants are the first to be provided under the emergency AIDS relief plan announced by President Bush early last year. They form part of a five-year, $9 billion program for HIV/AIDS prevention and treatment in 15 African and Caribbean countries.

Development experts like Rand Stoneburner, a former Centers for Disease Control epidemiologist, argue that studies have shown the abstinence model has the potential to reduce the AIDS rate in Africa's worst-hit countries by 80 percent, or the same level of efficacy expected from an HIV vaccine.

HIV experts, writing in the British Medical Journal earlier this month, called for a new focus on faithfulness in public health campaigns, saying reducing the number of sexual partners was often the aspect of the ABC approach that was most neglected.

We believe it is imperative to begin including messages about mutual fidelity and partner reduction in ongoing activities to change sexual behavior," they said. "Moreover, it seems important and feasible to promote monogamy and partner reduction alongside abstinence and use of condoms."

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