Monday, January 26, 2004

PORT-AU-PRINCE, Haiti — Hanging above crumbling streets, the giant blue banners urging Haitians to abstain from sex dwarf the tattered signs for Pante, the Caribbean nation’s best-selling condom.

The abstinence message, financed by the U.S. government, is getting mixed reviews in this impoverished nation, where earthly pleasures are scarce and HIV has infected 5 percent of the 8 million people.

Although HIV infection has leveled off in some age groups, it is increasing among Haitians aged 15 to 24. The country is one of the hardest-hit in the Caribbean, where the AIDS rate is second only to sub-Saharan Africa. At least 30,000 of the nearly 25 million AIDS deaths around the world have been in Haiti.

Supporters of the abstinence campaign say Haiti can learn from Uganda. The East African nation lowered its rate of infection from 15 percent to 5 percent after an “ABC” campaign promoting “a” for abstinence, “b” for “being faithful” in a monogamous relationship and “c” for condom use.

But Uganda’s economy is growing 5 percent a year, and it has high literacy and a stable government. Half of Haitians are illiterate, most are jobless in a shrinking economy, and international donors, disapproving of the elected government, have suspended aid.

“In Haiti, we cannot work with the government,” said Lester Munson, chief of staff for the Global Health Bureau of the U.S. government’s Agency for International Development. “In Uganda, President Yoweri Museveni was very committed publicly to fighting AIDS. In Haiti, it’s more complicated.”

Since flawed legislative elections in 2000, Haiti has been locked in a political impasse, with President Jean-Bertrand Aristide losing support at home and coming under increased pressure from abroad.

With just $130 million in assistance flowing into Haiti last year — $70 million of it in U.S. aid funneled to private groups — critics are asking whether money being used to promote abstinence could be better spent helping Haitians out of their deepening misery.

President Bush signed legislation last May for a $15 billion, five-year AIDS package for medical treatment, abstinence promotion, provision of condoms and other prevention programs in 15 African and Caribbean countries.

It earmarked about $900 million of that to promote abstinence in those countries. U.S. officials say previously, aid money for promoting abstinence wasn’t broken out separately, and they have no estimate on how much has gone to the campaign in Haiti.

In Haiti, the campaign is aimed at children.

“I try to tell girls they should wait, and if they wait, they have less chance of getting pregnant or getting AIDS,” said Jasmine Pomond, 19, a volunteer promoting the ABC campaign. “Before, when groups would only talk about condoms, kids used to think it was OK to run out and have sex.”

In a country where many girls start having sex at 13 and boys at 12, abstinence might be a tough sell — but condom use is up.

Last year, 14 million Pante condoms — pronounced “Pahn-TEH” in Creole — were sold, up from 12 million in 2001 and 10 million the year before, said Paul Hamilton of Population Services International. Sales also were up for female condoms, he said, especially among prostitutes, whose numbers have skyrocketed as poverty deepens.

For years, the organization has promoted the condom — whose trademark is a black panther with bedroom eyes — which sells for about 4 Haitian gourdes, just pennies.

Last year, the group spent more money on the abstinence campaign because of the Bush administration’s directive. Advocates of the approach say delaying the age at which children start having sex, even by a year, can save lives.

Shortly after Mr. Bush took office in 2001, he barred U.S. aid to international groups that use the money to perform or advocate abortions. Last year, he expanded that order, withholding aid for family planning from groups that promote or perform abortions overseas with their own money.

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