riage spending requirement can undermine the 
teams’ ability to design and implement pro-
grams that integrate the components of the 
ABC model, one of the guiding principles of the 
President’s Emergency Plan for AIDS Relief 
(PEPFAR) 
sexual 
transmission 
prevention 
strategy. Eight of the 15 focus country teams 
indicated that segregating the Abstinence and 
Be faithful components of the ABC model from 
‘‘other prevention’’ funding compromised the in-
tegration of their programs. Examples of the 
problems they cited include the following: 
(i) Segregating program funding com-
promises the integration of ABC activities, 
especially for at-risk groups that need com-
prehensive messages. 
(ii) Segregating program funding lim-
its some country teams’ ability to shift pro-
gram focuses to meet changing prevention 
needs. 
(B) A large majority of the 20 PEPFAR 
country teams required to meet the abstinence- 
until-marriage spending requirement or obtain 
exemptions reported that the requirement pre-
sented challenges to their efforts to respond to 
VerDate Aug 31 2005 
22:44 Jun 23, 2006
Jkt 049196
PO 00000
Frm 00016
Fmt 6652
Sfmt 6201
E:\BILLS\H5674.IH
H5674
rwilkins on PROD1PC63 with BILLS
local prevention needs. Seventeen of these 
teams reported, either through documents sub-
mitted to Office of the Global AIDS Coordi-
nator (OGAC) or through structured interviews, 
that meeting the spending requirement, includ-
ing OGAC’s 50 percent and 66 percent policies 
implementing it, challenged their ability to de-
velop interventions that are responsive to local 
epidemiology and social norms. 
(C) Between September 2005 and January 
2006, ten of these teams submitted documents 
to OGAC requesting exemption from the spend-
ing requirement as it was defined in OGAC’s 
August 2005 guidance. These documents high-
light various challenges that the country teams 
associated with meeting the spending require-
ment, including the following: 
(i) Reduced spending for Prevention 
of 
Mother 
to 
Child 
Transmission 
(PMTCT). 
(ii) Limited funding to deliver appro-
priate prevention messaging to high-risk 
groups. 
(iii) Lack of responsiveness to cultural 
and social norms. 
VerDate Aug 31 2005 
22:44 Jun 23, 2006
Jkt 049196
PO 00000
Frm 00017
Fmt 6652
Sfmt 6201
E:\BILLS\H5674.IH
H5674
rwilkins on PROD1PC63 with BILLS
(iv) Cuts in medical and blood safety 
activities. 
(v) Elimination of care programs. 
(D) In addition, seven teams that did not 
submit documents requesting exemption from 
the spending requirement (they did not meet 
OGAC’s proposed criteria for requesting exemp-
tions) identified, in structured interviews, spe-
cific program constraints related to meeting the 
abstinence-until-marriage spending requirement. 
These constraints included the following: 
(i) Difficulty reaching certain popu-
lations with comprehensive ABC messages. 
(ii) Limited or reduced funding for 
programs targeted at high-risk groups. 
(iii) Reduced funding for PMTCT 
services. 
(iv) Difficulty funding programs for 
condom procurement and condom social 
marketing. 
(b) STATEMENT OF POLICY.—In carrying out the ac-
tivities required by the United States Leadership Against 
HIV/AIDS, Tuberculosis, and Malaria Act of 2003 (Public 
Law 108–25; 22 U.S.C. 7601 et seq.) and the amend-
VerDate Aug 31 2005 
22:44 Jun 23, 2006
Jkt 049196
PO 00000
Frm 00018
Fmt 6652
Sfmt 6201
E:\BILLS\H5674.IH
H5674
rwilkins on PROD1PC63 with BILLS
ments made by that Act, it shall be the policy of the 
United States— 
(1) to provide flexibility to support the imple-
mentation of culturally appropriate HIV prevention 
programs that are carried out in accordance with the 
global HIV prevention strategy established pursuant 
to section 3 of this Act; 
(2) to ensure that onerous requirements are not 
imposed with respect to how funds made available 
for such programs can be obligated and expended; 
and 
(3) to prevent the unnecessary reduction in 
funding for effective HIV programs in order to meet 
such onerous requirements. 
(c) AMENDMENTS
TO FUNDING PROVISIONS
OF 
UNITED STATES LEADERSHIP AGAINST HIV/AIDS, TU-
BERCULOSIS, AND MALARIA ACT OF 2003.— 
(1) SENSE OF CONGRESS.—Section 402(b)(3) 
of the United States Leadership Against HIV/AIDS, 
Tuberculosis, and Malaria Act of 2003 (22 U.S.C. 
7672(b)(3)) is amended by striking ‘‘, of which such 
amount at least 33 percent should be expended for 
abstinence-until-marriage programs’’. 
VerDate Aug 31 2005 
22:44 Jun 23, 2006
Jkt 049196
PO 00000
Frm 00019
Fmt 6652
Sfmt 6201
E:\BILLS\H5674.IH
H5674
rwilkins on PROD1PC63 with BILLS
(2) ALLOCATION OF FUNDS.—Section 403(a) of 
such Act (22 U.S.C. 7673(a)) is amended by strik-
ing the second sentence. 
SEC. 5. DEFINITIONS. 
In this Act: 
(1) AIDS.—The term ‘‘AIDS’’ means the ac-
quired immune deficiency syndrome. 
(2) APPROPRIATE
CONGRESSIONAL
COMMIT-
TEES.—The term ‘‘appropriate congressional com-
mittees’’ means the Committee on International Re-
lations of the House of Representatives and the 
Committee on Foreign Relations of the Senate. 
(3) HIV.—The term ‘‘HIV’’ means the human 
immunodeficiency virus, the pathogen that causes 
AIDS. 
(4) 
HIV/AIDS.—The 
term 
‘‘HIV/AIDS’’ 
means, with respect to an individual, an individual 
who is infected with HIV or living with AIDS. 
Æ 
VerDate Aug 31 2005 
22:44 Jun 23, 2006
Jkt 049196
PO 00000
Frm 00020
Fmt 6652
Sfmt 6301
E:\BILLS\H5674.IH
H5674
rwilkins on PROD1PC63 with BILLS