U.S. Attaches Strings to AIDS Money

The United States is requiring AIDS groups that take government funding to adopt an explicit policy opposing the sex trade. The requirement has already prompted Brazil to turn down $40 million in U.S. funds. Groups say the requirement could make it more difficult to work with at-risk groups, such as prostitutes.

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It's being called the loyalty oath by critics. The US government is expected to announce that it will require all organizations that get federal AIDS money to sign an agreement to oppose prostitution. Federal officials say it's part of an effort to stop the trafficking of human beings for sex or slave labor, but many health organizations here and abroad say it will make their work more difficult. NPR's Brenda Wilson reports.

BRENDA WILSON reporting:

The primary source of HIV transmission the world over is sex, a transaction that, in many instances, take place among people on the margins of society, in red-light districts--people who have been abused and have no other way of earning money. They are considered criminals and live in fear of outsiders and authority. Susan Cohen of the Alan Guttmacher Institute, a reproductive health research group, says the new regulations requiring health organizations to openly oppose prostitution will harm efforts to fight AIDS.

Ms. SUSAN COHEN (Alan Guttmacher Institute): How do you think that those women feel when a US organization comes to them and says, `We want to help you. We want prevent HIV. We want to help save your lives and protect your health. But we must inform you that we oppose what you do. We oppose what you do to survive economically. And so let's just state that for the record, and now let's just go ahead and work together.

WILSON: These are groups that might recruit sex workers or prostitutes to participate in tests of vaccines. They might, as one Latin American group does, operate safe houses where men and women engaged in the sex trade can go for counseling and services without fear of being pursued by the police and the courts. Some may only work on prevention of mother-to-child transmission of AIDS.

Ms. COHEN: They have nothing to do with sex workers. There's no reason they should have a position, pro or con, on the issue of prostitution, but they will be forced to adopt one.

WILSON: Nearly 200 organizations and individuals have signed a letter asking the White House to withdraw the policy, but many who are directly affected by it would not speak openly about their concerns. Again, Susan Cohen of the Guttmacher Institute.

Ms. COHEN: Because there's a lot of money on the table here. They're using millions of US government dollars to save millions of lives.

WILSON: The new policy is similar to an existing rule that bars organizations from getting family planning money if they are involved in or have ties to groups that provide abortion counseling or services, even if government money is not used for those services. But that policy isn't applied to US groups because of concerns about violating the constitutional right to free speech.

President Bush's global AIDS coordinator, Ambassador Randall Tobias, was not available to speak about the new policy, but at a congressional hearing last month, he was asked about the constitutional question and did not address it directly.

Ambassador RANDALL TOBIAS (Global AIDS Coordinator for President Bush): We have no policy and no intent to exclude any group of persons from services who need these services. And, in fact, I have visited programs that we are funding that--where we are trying to provide job skills, for example, to get prostitutes out of sex work.

WILSON: US AIDS workers say if allowed to stand this policy sets a precedent. In a matter of time, they say, US groups that receive family planning funds could be prohibited from speaking in favor of the right to an abortion. Brenda Wilson, NPR News, Washington.

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