(A) ensures that the program, project, or 
activity funded by such amounts are made 
available to all elements of the population, ex-
cept to the extent that such program, project, 
or activity targets a population because of the 
higher assessed risk of negative outcomes 
among such populations; 
(B) undertakes to make every reasonable 
effort to ensure that each subcontractor or sub-
grantee of such recipient will also adhere to the 
requirement described in subparagraph (A); and 
(C) agrees to return all amounts awarded 
or otherwise provided by the United States, in-
cluding such additional penalties as the Sec-
retary of State may determine to be appro-
priate, if the recipient is not able to adhere to 
the requirement described in subparagraph (A). 
(2) QUARTERLY
REPORT.—The Secretary of 
State shall provide to the appropriate congressional 
committees a quarterly report on the methods by 
which the Department monitors compliance with the 
requirement in paragraph (1)(A). 
(g) OFFICE OF FOREIGN ASSISTANCE.—The Sec-
retary of State, acting through the Director of the Office 
of Foreign Assistance, shall monitor the amount of foreign 
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assistance obligated and expended on programs, projects, 
and activities relating to LGBTQI people, and shall pro-
vide the results of the indicators tracking such expendi-
ture, upon request, to the Organization for Economic Co- 
operation and Development. 
SEC. 7. GLOBAL HEALTH INCLUSIVITY. 
(a) IN GENERAL.—The Coordinator of United States 
Government Activities to Combat HIV/AIDS Globally 
shall develop mechanisms to ensure that the President’s 
Emergency Plan for AIDS Relief (PEPFAR) is imple-
mented in a way that equitably serves LGBTQI people 
in accordance with the goals described in section 6(f), in-
cluding by requiring all partner entities receiving assist-
ance through PEPFAR to receive training on the health 
needs of and human rights standards relating to LGBTQI 
people, and shall promptly notify Congress of any obsta-
cles encountered by a foreign government or contractor, 
grantee, or implementing partner in the effort to equitably 
implement PEPFAR as described in such subsection, in-
cluding any remedial steps taken by the Coordinator to 
overcome such obstacles. 
(b) REPORT ON INTERNATIONAL PROSECUTIONS FOR 
SEX WORK OR CONSENSUAL SEXUAL ACTIVITY.—Not 
later than 180 days after the date of the enactment of 
this Act, the Coordinator shall submit to the appropriate 
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congressional committees a report describing the manner 
in which commodities such as condoms provided by pro-
grams, projects, or activities funded through PEPFAR or 
other sources of United States assistance have been used 
as evidence to arrest, detain, or prosecute individuals in 
other countries in order to enforce domestic laws criminal-
izing sex work or consensual sexual activity. 
(c) REPORT ON HIV/AIDS-RELATED INDEX TEST-
ING.—Not later than 180 days after the date of the enact-
ment of this Act, the Coordinator shall submit to the ap-
propriate congressional committees a report describing the 
impact of partner notification services and index testing 
on treatment adherence, intimate partner violence, and ex-
posure to the criminal justice system for key populations, 
including LGBTQI people and sex workers, using quali-
tative and quantitative data. 
(d) REPORT ON IMPACT OF ‘‘GLOBAL GAG’’ RULE.— 
Not later than 180 days after the date of the enactment 
of this Act, the Comptroller General shall submit to the 
appropriate congressional committees a report describing 
the impact, as of the date of the submission of the report, 
on the implementation and enforcement of any iteration 
of the Mexico City Policy on the global LGBTQI commu-
nity. 
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(e) REMOVING LIMITATIONS ON ELIGIBILITY FOR 
FOREIGN ASSISTANCE.— 
(1) IN GENERAL.—Notwithstanding any other 
provision of law, regulation, or policy, in determining 
eligibility for assistance authorized under part I of 
the Foreign Assistance Act of 1961 (22 U.S.C. 2151 
et seq.), a foreign nongovernmental organization— 
(A) shall not be ineligible for such assist-
ance solely on the basis of health or medical 
services, including counseling and referral serv-
ices, provided by such organizations solely using 
funds not provided by the United States Gov-
ernment, if such services do not violate the laws 
of the country in which they are being provided 
and would not violate Federal law if provided in 
the United States; and 
(B) shall not be subject to requirements 
relating to advocacy and lobbying activities with 
respect to funds not provided by the United 
States Government, other than requirements re-
lating to such activities that also apply to 
United States nongovernmental organizations 
receiving assistance authorized under such part 
I. 
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(2) CONFORMING AMENDMENTS TO PEPFAR AU-
THORIZATION.—Section 301 of the United States 
Leadership Against HIV/AIDS, Tuberculosis, and 
Malaria Act of 2003 (22 U.S.C. 7631) is amended— 
(A) by striking subsections (d) through (f); 
and 
(B) by redesignating subsection (g) as sub-
section (d). 
(3) CONFORMING AMENDMENTS TO THE ALLO-
CATION OF FUNDS BY THE GLOBAL AIDS COORDI-
NATOR.—Section 403(a) of the United States Lead-
ership Against HIV/AIDS, Tuberculosis, and Ma-
laria Act of 2003 (22 U.S.C. 7673(a)) is amended— 
(A) in paragraph (1)— 
(i) by striking ‘‘shall—’’ and all that 
follows through ‘‘(A) provide’’ and insert-
ing ‘‘shall provide’’; 
(ii) by striking ‘‘; and’’ and inserting 
a period; and 
(iii) by striking subparagraph (B); 
and 
(B) in paragraph (2)— 
(i) by striking ‘‘PREVENTION STRAT-
EGY.—’’ and all that follows through ‘‘In 
carrying out paragraph (1)’’ and inserting 
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