HIV Prevention for Youth Act - Expresses the sense of Congress that sexually active young people who live in a country where HIV infection is spreading through the general population, rather than being confined to specific populations should be: (1) considered at high risk of contracting HIV infection; and (2) provided with the knowledge, skill-building programs, and tools to protect themselves from HIV infection.
Amends the United States Leadership Against HIV/AIDS, Tuberculosis, and Malaria Act of 2003 to define "abstinence-until-marriage programs" as programs that place the highest priority on encouraging unmarried individuals to abstain from sexual activity, which if practiced 100% correctly and consistently is the only certain way to protect against exposure to HIV and other sexually transmitted infections. (Such programs include information on the health benefits of delayed sexual debut in reducing HIV transmission and may be used to support approaches that promote skill-building strategies for practicing abstinence.) Reserves at least 33% of the Act's appropriations for FY2006-FY2008 for prevention of the sexual transmission of HIV (currently, for HIV/AIDS prevention).
Amends the Foreign Assistance Act of 1961 to include within the activities for which HIV/AIDS assistance is available preventive intervention education for sexually active young people who live in a country experiencing a generalized HIV epidemic.
Defines " generalized epidemic" as a country where: (1) HIV infection is spreading through the general population, rather than being confined to specific populations, such as sex workers and their clients, injecting drug users, and men who have sex with men; and (2) the HIV infection rate among people between the ages of 15 and 49 exceeds 1%.
[Congressional Bills 109th Congress]
[From the U.S. Government Publishing Office]
[S. 3656 Introduced in Senate (IS)]
109th CONGRESS
2d Session
S. 3656
To provide additional assistance to combat HIV/AIDS among young people,
and for other purposes.
_______________________________________________________________________
IN THE SENATE OF THE UNITED STATES
July 13, 2006
Mrs. Feinstein (for herself and Ms. Snowe) introduced the following
bill; which was read twice and referred to the Committee on Foreign
Relations
_______________________________________________________________________
A BILL
To provide additional assistance to combat HIV/AIDS among young people,
and for other purposes.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``HIV Prevention for Youth Act''.
SEC. 2. FINDINGS.
Congress makes the following findings:
(1) The President's Emergency Plan for AIDS Relief (in this
Act referred to as ``PEPFAR'') is an unprecedented effort to
combat the global AIDS epidemic, with $9,000,000,000 targeted
for initiatives in 15 focus countries.
(2) The PEPFAR prevention goal is to avert 7,000,000 HIV
infections in the 15 focus countries--most in sub-Saharan
Africa where heterosexual intercourse is by far the predominant
mode of HIV transmission.
(3) The PEPFAR strategy for prevention of sexual
transmission of HIV is shaped by 3 elements: the ABC model,
defined as ``Abstain, Be faithful, use Condoms'', the promotion
of ``abstinence-until-marriage'', and deference to local
prevention needs.
(4) The United States Leadership Against HIV/AIDS,
Tuberculosis, and Malaria Act of 2003 requires that at least
one-third of all prevention funds be reserved for abstinence-
until-marriage programs. In implementing this requirement, the
U.S. Global AIDS Coordinator has required that 50 percent of
prevention funding be dedicated to sexual transmission
prevention activities. This requirement severely limits
countries from employing strategies for the prevention of
sexual transmission other than abstinence, because the other
sexual transmission prevention programs under PEPFAR (such as
the purchase of condoms and management of sexually transmitted
infections) cannot exceed one-sixth of the total prevention
funds.
(5) The Government Accountability Office (GAO) issued a
report in April, 2006, ``Spending Requirement Presents
Challenges For Allocating Funding under the President's
Emergency Plan for AIDS Relief'', that found ``significant
challenges'' associated with meeting the earmark for
abstinence-until-marriage programs.
(6) GAO found that a majority of country teams report that
fulfilling the requirement presents challenges to their ability
to respond to local epidemiology and cultural and social norms.
(7) GAO found that, although some country teams may be
exempted from the abstinence-until-marriage spending
requirement, country teams that are not exempted have to spend
more than the 33 percent of prevention funds on abstinence-
until-marriage activities--sometimes at the expense of other
programs.
(8) Indeed, according to GAO, the proportion of HIV
prevention funds dedicated to ``other prevention'' activities
(i.e. the purchase and promotion of condoms, management of
sexually transmitted infections other than HIV, and messages or
programs to reduce injection drug use) declined from 23 percent
in fiscal year 2005 to 18 percent in fiscal year 2006 for
country teams that did not receive exemptions.
(9) GAO found that, as a result of the abstinence-until-
marriage spending requirement, some countries have had to
reduce planned funding for Prevention of Mother-to-Child
Transmission programs, thereby limiting services for pregnant
women and their children.
(10) GAO found that the abstinence-until-marriage spending
requirement limited or reduced funding for programs directed to
high-risk groups, such as services for married discordant
couples, sexually active youth, and commercial sex workers.
(11) GAO found that the abstinence-until-marriage spending
requirement made it difficult for countries to fund medical and
blood safety activities.
(12) GAO found that, because of the abstinence-until-
marriage spending requirement, some countries would likely have
to reduce funding for condom procurement and condom social
marketing.
(13) In addition, GAO found that two-thirds of focus
country teams reported that the policy for implementing the ABC
model is unclear and open to varying interpretations, causing
confusion about which groups may be targeted and whether youth
may receive the ABC message.
(14) GAO found that the ABC guidance does not clearly
delineate permissible C activities under the ABC model. Program
staff reported that they feel ``constrained'' by restrictions
on promoting or marketing condoms to youth. Other country teams
reported confusion about whether PEPFAR funds may be used for
broad condom social marketing, even to adults in a generalized
epidemic.
(15) Each day, an estimated 13,400 people worldwide are
newly infected with HIV.
(16) Sub-Saharan Africa is home to almost two-thirds of the
estimated 40,000,000 people currently living with HIV.
(17) In many African countries, the epidemic has spread
among the general population. The HIV prevalence rate for the
general population is 8 percent across sub-Saharan Africa.
Among the United States focus countries in sub-Saharan Africa,
the HIV prevalence rate ranges from 4 percent in Uganda to 37
percent in Botswana.
(18) According to the Joint United Nations Programme on
HIV/AIDS, young people between the ages of 15 and 24 are ``the
most threatened by AIDS'' and ``are at the centre of HIV
vulnerability''. Globally, this age group accounts for half of
all new HIV cases each year. More than 7,000 young people
contract the virus every day.
(19) Most young people in sub-Saharan Africa have sex
before marriage during their adolescent years. In many
countries, at least half of all women have sex before age 20
and before marriage. Among young men, more than 70 percent have
premarital sex before age 20.
(20) Many adolescents, who are sexually active and not yet
married, have inadequate information on how to protect
themselves against HIV. Fewer than half of young people in sub-
Saharan Africa mention abstinence, monogamy, or condom use as a
way of avoiding HIV.
(21) Young people who have sex are at greater risk of
acquiring HIV than adults, partly because of their lack of
knowledge. They are apt to change partners frequently, have
more than 1 partner in the same time period, or engage in
unprotected sex.
(22) Coercion and sexual violence undercut the ability of
young people--women in particular--to prevent HIV and
contribute to the vulnerability to infection. In addition,
gender inequality makes it much more difficult for young women
to negotiate abstinence from sex or to insist that their
partners remain faithful or use condoms.
(23) Marriage does not protect young women from HIV, even
when they are faithful to their husbands. In some settings, it
appears marriage actually increases a woman's HIV risk. In some
African countries, married women aged 15-19 have higher HIV
infection levels than nonmarried sexually active women of the
same age.
(24) A recent USAID-funded review found that sex and HIV
education programs that encourage abstinence but also discuss
the use of condoms do not increase sexual activity as critics
of sex education have long alleged. Sex education can help
delay the initiation of intercourse, reduce the frequency of
sex and the number of sexual partners, and also increase condom
use.
(25) Young people are our greatest hope for changing the
course of the AIDS epidemic. According to the World Health
Organization, ``Focusing on young people is likely to be the
most effective approach to confronting the epidemic,
particularly in high prevalence countries.''.
SEC. 3. SENSE OF CONGRESS.
It is the sense of Congress that sexually active young people, both
unmarried and married, who live in a country where HIV infection is
spreading through the general population, rather than being confined to
specific populations, such as sex workers and their clients, injecting
drug users, and men who have sex with men, and the rate of HIV
infection among people between the ages of 15 and 49 exceeds 1 percent
should be--
(1) considered at high risk of contracting HIV infection;
and
(2) provided with the knowledge, skill-building programs,
and tools to protect themselves from HIV infection, including--
(A) medically accurate information on public health
benefits and failure rates of multiple strategies for
eliminating or reducing the risks of contracting HIV
and other sexually transmitted infections; and
(B) information about correct and consistent use of
condoms as well as abstinence and the importance of
reducing casual sexual partnering.
SEC. 4. ALLOCATION OF FUNDS.
Section 403 of the United States Leadership Against HIV/AIDS,
Tuberculosis, and Malaria Act of 2003 (22 U.S.C. 7673) is amended--
(1) in subsection (a), in the second sentence, by striking
``HIV/AIDS prevention'' and inserting ``prevention of the
sexual transmission of HIV''; and
(2) by adding at the end the following new subsection:
``(c) Abstinence-Until-Marriage Programs.--The term `abstinence-
until-marriage programs' means programs that place the highest priority
on encouraging individuals who have not yet married to abstain from
sexual activity, which if practiced 100 percent correctly and
consistently is the only certain way to protect against exposure to HIV
and other sexually transmitted infections. The programs include
information on the health benefits of delayed sexual debut in reducing
the transmission of HIV and may be used to support the wide range of
approaches that promote skill-building strategies for practicing
abstinence.''.
SEC. 5. ASSISTANCE TO YOUNG PEOPLE.
Section 104A(d)(3) of the Foreign Assistance Act of 1961 (22 U.S.C.
2151b-2(d)(3)) is amended--
(1) in subparagraph (A), by inserting ``sexually active
young people, both unmarried and married, who live in a country
experiencing a generalized HIV epidemic,'' after ``infected
with HIV/AIDS,''; and
(2) by adding at the end the following new subparagraph:
``(C) In subparagraph (A), the term `generalized epidemic'
means, with respect to a country, that--
``(i) HIV infection is spreading through the
general population of such country, rather than being
confined to specific populations, such as sex workers
and their clients, injecting drug users, and men who
have sex with men; and
``(ii) the rate of HIV infection among people
between the ages of 15 and 49 exceeds 1 percent.''.
<all>
Introduced in Senate
Sponsor introductory remarks on measure. (CR S7517-7518)
Read twice and referred to the Committee on Foreign Relations. (text of measure as introduced: CR S7518-7519)
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