Is there a role for abstinence only programmes for HIV prevention in high income countries?

BMJ 2007; 335 doi: http://dx.doi.org/10.1136/bmj.39287.463889.80 (Published 2 August 2007)
Cite this as: BMJ 2007;335:217

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  1. Stephen E Hawes, assistant professor1,
  2. Papa Salif Sow, professor2,
  3. Nancy B Kiviat, professor3
  1. 1Department of Epidemiology, University of Washington School of Public Health, Box 359933 Seattle, WA, 98195-7230, USA
  2. 2Department of Infectious Diseases, University of Dakar, BP 5005, Senegal
  3. 3Department of Pathology, University of Washington, Box 359791, Seattle, WA 98104
  1. nbk@u.washington.edu

    A robust systematic review finds no evidence that such programmes reduce risky sexual behaviours, incidence of sexually transmitted infections, or pregnancy

    The systematic review in this week's BMJ by Underhill and colleagues brings valuable insights to a highly contentious issue: whether abstinence only (as opposed to abstinence plus) programmes can stop, delay, or decrease sexual activity and prevent HIV infection.1 This question is important because 38 million people are currently infected with HIV but, despite 25 years of research, we still have no vaccines to prevent HIV infection. Furthermore, HIV prevention has become a politically charged issue because funds from the US President's Emergency Plan for AIDS Relief (PEPFAR) can be used for abstinence only programmes, but cannot be used for other safer sex strategies, needle exchange, or instructions for using condoms. Is this an effective use of public funds?2

    A previous review of abstinence only programmes in the developing world, presented at …

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