142nd APHA Annual Meeting and Exposition

Annual Meeting Recordings are now available for purchase

Did PEPFAR Impact the ABCs of HIV Prevention?

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Tuesday, November 18, 2014

Ashley Fox, PhD, MA , Department of Health Evidence and Policy, Mount Sinai School of Medicine, New York, NY
Madison Little , Rutgers University, New Brunswick, NJ

Background: The President’s Emergency Plan for AIDS Relief (PEPFAR) is former President Bush’s signature global health initiative, which channeled billions of dollars into the global HIV/AIDS epidemic in 15 focal countries since 2004. Thirty percent of this global funding went towards PEPFAR’s controversial prevention policies, including its ABC approach (Abstain, Be faithful, Condomize).  This investigation was undertaken to assess the impact of PEPFAR funding on sexual behavior relating to the ABCs of prevention in PEPFAR focal countries compared with similar countries that did not receive PEPFAR funding. Methods: Country-level data on five variables among youth—abstinence, multiple partners, condom use, and sex before the ages of 15 and 18—were collected from nationally-representative Demographic and Health Surveys. Nine PEPFAR-focus countries and five non-PEPFAR-focus countries in sub-Saharan Africa with data supporting pre-PEPFAR (1999-2003) and PEPFAR (2004-2011) years were selected for evaluation.    Results: Paired samples t-tests and Wilcoxon non-parametric tests were conducted to assess differences in the change in mean prevalence rates of behavioral variables between PEPFAR and non-PEPFAR countries in the pre-PEPFAR and PEPFAR periods.  The results showed that the means of the variables from PEPFAR-focus countries were not significantly different from controlson any of the four variables assessed including pre-marital abstinence (p-values ranging from 0.51 to 0.92).  Conclusion: These results suggest that PEPFAR behavioral prevention funding has not had a substantial impact on sexual behavior in spite of the billions of dollars invested in these programs.

Learning Areas:

Public health or related public policy
Social and behavioral sciences

Learning Objectives:
Evaluate the impact of PEPFAR prevention funding on sexual behaviors of youth. Compare changes in youth sexual behaviors in countries that received PEPFAR funding and countries that did not receive PEPFAR funding. Assess the effectiveness of AIDS aid on adolescent sexual health outcomes.

Keyword(s): HIV/AIDS, Public Policy

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a co-author on this work and have been primarily responsible for the primary data analysis for the project.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.