The U.S. effort to combat AIDS

Re “Sex and the State Dept.,” Opinion, May 2

To suggest we not teach people effective ways to avoid HIV because some will not use them is like saying we should not teach people to avoid smoking because some will smoke anyway. The assumption that behavior change is impossible is factually inaccurate -- and it’s deadly.

Data from Africa show declines in HIV prevalence associated with all of the “ABC” behaviors (abstinence, being faithful, correct and consistent use of condoms), and the president’s emergency plan for AIDS relief supports all three. Peter Piot of UNAIDS noted that the United States “is by far the biggest supplier of condoms in the world, more than all the rest of the donors together.”

Condom-related programs receive 6% of our program funds, while abstinence/faithfulness programs combined receive 7.1%. As shown in Thailand, men can reduce dramatically the frequency of visiting prostitutes. The U.S. government opposes prostitution and sex trafficking because they spread HIV and demean women, yet we support many programs that work with people engaged in prostitution.

As Piot has said: “You can’t work on AIDS if you don’t work with sex workers.” We must replace HIV/AIDS dogmas on all sides with evidence-based public health.

AMBASSADOR MARK DYBUL MD

Global AIDS coordinator

Department of State

Washington