Can Faith-based Organizations Teach Both ABCs and Healthy Sexuality in Africa?

From 2004 to 2010 the Bush administration funded through PEPFAR several US faith-based organizations to encourage “ABC”, teaching sexual abstinence and faithfulness (and, in some cases, increased awareness of condoms) to African youth. A qualitative evaluation of one such USAID-funded FBO program in three African countries indicates that many young participants--particularly younger teens—seemed to learn and appreciate the importance of self-esteem, postponing sexual intercourse, and avoiding unwanted relationships as well as the risks of STIs. This ABC course tended to emphasize warnings against unhealthy aspects of early and casual sexual behaviors; yet participants in these peer-led discussions, engaging boys and girls together in story-telling, role-playing, and discussion, appeared to learn much more than they had learned before the program from naïve peers and reluctant parents. This paper presents an independent evaluator's subjective, qualitative view based on interviews of over 200 participants about the program's efforts to balance the traditional negative warnings of the physical and moral risks of sex with more positive views of sexuality. Only a clinic-based quantitative evaluation based on voluntary confidential testing for STIs, HIV/AIDS, pregnancy, gender-based violence, and drug abuse can reliably measure program effectiveness, but this study suggests the cost-effectiveness of enlisting long-established widespread networks of trusted, committed faith-based groups working in African churches, schools, clinics, and communities to prevent AIDS transmission to the future generations, particularly in settings where discussions about sexuality have long been taboo, especially when treatments continue to be unavailable to the majority of Africans living with HIV and AIDS.