Bush ‘morality’ cuts funding for HIV education in Central America

It would seem to be common sense that those who are members of a given community would know the best way to reach out to that community. This is exactly the approach that a program organized by Population Services International has used to tackle the crisis of HIV/AIDS in Central America.

This work could not be needed more. The World Bank reported in 2003 that four of the six Latin American countries with the highest prevalence of HIV/AIDS are in Central America. According to the Baltimore Sun, the rate of HIV among prostitutes in Central America is as high as 20 percent.

A report released in 2002 by the National University of Costa Rica cited irregular use of condoms by sex workers in Central America as a factor in the high risk of infection with the AIDS virus. Only one percent of the 1,600 prostitutes they surveyed throughout the region knew the proper way to use a condom. The report recommended an increase in educational outreach to sex workers, and that organizations “take into account the cultural differences of the population” when decisions are made about allocation of resources. (AFP)

Through the PSI program, former prostitutes use a two-pronged approach to educating current prostitutes about the disease. One aspect is the organization of Loteria games, using the game’s icons to explain aspects of safer sex and condom use. Loteria is a popular and well-loved game throughout much of Central America, and as such creates a comfortable setting for prostitutes to learn about these topics.

The other aspect is outreach in the brothels and bars where prostitutes work. The outreach specialists sit down with prostitutes and explain how to use a condom, and the importance of safer sex.

The Baltimore Sun reports: “Last year, PSI’s program made contact with 422,000 people in high-risk groups and sold 14 million condoms in the region. In parts of Guatemala, where PSI has significantly expanded its work, HIV infections among prostitutes have fallen by a third.”

Despite the success of this program, a U.S. senator has denounced the funding of PSI by the United States Agency for International Development. In a letter, Sen. Tom Coburn of Oklahoma belittled the organization of the Loteria games, writing, “There is something seriously askew at USAID when the agency’s response to a dehumanizing and abusive practice that exploits women and young girls is parties and games.” And Coburn said that the Noches Vives program of going into the bars and brothels was a “misuse of funds to organize and sponsor parties and dance contests to exploit victims of the sex trade.”

Other senators have denounced Coburn’s letter, but only in the most chauvinistic terms. Larry Craig of Idaho said that “ignoring the problem by hamstringing proven programs is a disservice to U.S. citizens who are impacted by the wave of immigrants from these countries.”

Both responses to an effective program completely ignore the base issue of HIV/AIDS in Central America. If these senators are really concerned with the “dehumanizing and abusive” practice of prostitution and the “wave of immigrants,” they can focus their energy on the economic and political realities of capitalism—which not only force many women and men into prostitution, but also force many women and men to leave their families behind and seek work in the United States. But they should leave the fighting of a world pandemic to the medical experts on HIV/AIDS and members of communities that are most affected by it.

After Coburn’s letter was released, USAID contacted PSI to tell them that future funding for the organization--almost half of PSI’s budget— had been denied. The Sun reports that while decisions on contracts are usually made by USAID officials with expertise in the area being addressed, this decision was made by a “high-level political appointee.”

This USAID ruling must be seen in the context of the larger push by the religious right to use “morality” to guide health policies. In 2003 Congress passed President George W. Bush’s Global AIDS Initiative, which has not only siphoned money from realistic AIDS education programs to abstinence-only programs, but also denies funds to “any group or organization that does not have a policy explicitly opposing prostitution and sex trafficking.” Last year, this requirement was extended from international to U.S.-based groups.

True morality lies within the hearts of the people who fight for their rights, including the right to accurate and reliable sex education for themselves and their communities; it is not dictated by a group of naysayers who place “family values” over the saving of lives. An intensified response on the streets is needed to combat the intensification of the right-wing attack on the lives of women and men worldwide.