AIDS, like many other diseases, tends to disproportionately affect marginalized populations. In the case of Africa, this has especially sensitive implications for women, who traditionally live in circumstances of sexual, societal, political and economic subordination. Because of these factors, the politics of blame becomes an especially subtle and delicate obstacle for HIV-prevention programs.

And yet, PEPFAR, the President's Emergency Plan For AIDS Relief, bypasses any thought to the cultural or structural disparities between the United States and, say, the rest of the world (I know, shocking...). This plan uses the most epidemiologically vulnerable countries in the world as a playground  to spread the faith-based wet dreams of our conservative leaders. Oh, and <a href="http://www.rhrealitycheck.org/blog/2008/02/27/pepfar-wins-money-compromises-principle">the House just reauthorized it for five more years.</a>

There are so many dangerous aspects to PEPFAR, the consequences of which are only apparent after <a href="http://www.pepfar2.org/legislationsuggestions.html">parsing the entire policy</a>(in conjunction with other global AIDS relief policies that have been put into place by the administration):

*The ABC plan basically stipulates that the use of condoms can only be addressed to an audience of "high-risk" groups. This is dangerous because it identifies marital status, age, and occupation as factors that would place someone within or outside of this category, when often these factors hide risky behavior or environments. To assume that marriage makes someone safe from exposure to the virus is ignoring many structural limitations of target countries that put women in lesser, subordinate roles that often result in their safety being compromised even within supposed "safe" relationships (a study shows that the majority of HIV positive women in Uganda are contracting the virus within marriage) . The other reason ABC is dangerous is because limiting condom teaching to "risk groups" further stigmatizes the use of condoms in an environment that already has a long history of condemning this resource

*Two other policies that work in conjunction with PEPFAR are the "Global Gag Rule" and the "<a href="http://www.genderhealth.org/loyaltyoath.php">Prostitution Loyalty Oath.</a>" The latter is a policy that was passed in Congress in 2003 which denies federal funding HIV prevention groups who work with prostitutes in any capacity. Many of these groups are doing important work to not only make sure that sex workers (and the sex trade industry is a significant, significant factor in the widespread HIV transmission in Africa and Asia) stay uninfected, practice safe sex and avoid spreading the virus to clients if they are infected, but also to teach female empowerment not only in the women's capacity to negotiate the terms of sexual intercourse but providing resources to find alternative employment and career advancement in other fields. These groups are now denied federal funding.

*The "<a href="http://www.huffingtonpost.com/deborah-orrick/lifting-the-gag-rule-on-d_b_90860.html">Global Gag Rule</a>" denies federal funding to AIDS relief groups that combine HIV prevention programming with family planning. These groups have provided important programs because combining their prevention/treatment programming with family planning provides a more acceptable gateway into these programs in environments that highly stigmatize the disease.

This is an extremely flawed policy that aims to spread the faith-based policies of abstinence-only, risk elimination and the stigmatization of family planning, to the developing world while wrapped in the guise of well-meaning global aid. We cannot allow the complacency that comes from the warm and fuzzy feelings we get from the phrase "AIDS relief" to mask the inherent imperialistic guile policies like PEPFAR enforce.