ment in countries for which the United States provides 
assistance to combat HIV/AIDS, based on the strategies 
specified under subsection (b), and shall submit to the ap-
propriate congressional committees and make available to 
the public such guidance. Such guidance shall also include 
operational definitions and a clear articulation of accept-
able and prohibited activities related to funding limitations 
for 
organizations 
working 
with 
vulnerable 
and 
marginalized populations such as commercial sex workers, 
in accordance with subsections (e) and (f) of section 301 
of the United States Leadership Against HIV/AIDS, Tu-
berculosis, and Malaria Act of 2003 (Public Law 108–25; 
22 U.S.C. 7631). 
(e) MONITORING AND EVALUATION SYSTEM.— 
(1) IN GENERAL.—The President shall develop 
and implement a monitoring and evaluation system 
in order to measure the effectiveness of United 
States assistance in preventing HIV infection among 
women and girls and in addressing the factors that 
lead to gender disparities in the rate of HIV infec-
tion. 
(2) REQUIREMENTS.—For each of the countries 
for which the United States provides assistance to 
combat HIV/AIDS, and in consultation with na-
tional governments, international organizations, in-
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digenous organizations, and other donor countries, 
the monitoring and evaluation system under this 
subsection shall— 
(A) establish performance goals for such 
assistance and express such goals in an objec-
tive and quantifiable form, to the maximum ex-
tent practicable; 
(B) establish performance indicators to be 
used in measuring or assessing the achievement 
of the performance goals established pursuant 
to subparagraph (A); 
(C) measure rates of HIV incidence and 
prevalence among women and girls by age and 
marital status; 
(D) measure rates of marriage for girls 
under the age of 18; 
(E) measure rates for children in school; 
(F) measure access rates to primary health 
care, including primary reproductive health and 
HIV prevention programs, services, and tech-
nologies; 
(G) measure utilization rates by married 
and unmarried women of HIV prevention serv-
ices and commodities directly funded or sup-
ported by the United States; 
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(H) measure rates of reported gender- 
based violence and sexual coercion; and 
(I) measure the prevalence of social norms 
and beliefs supporting gender-based violence 
among women and men, to the maximum extent 
practicable. 
(3) USE OF SCIENTIFIC SURVEYS.—Where ap-
propriate, the President may utilize any existing sci-
entific surveys to augment the measurements re-
quired under subparagraphs (C) through (I) of para-
graph (2). 
(f) REPORT.—Not later than one year after the date 
of the enactment of this Act and annually thereafter as 
part of the annual report required under section 104A(e) 
of the Foreign Assistance Act of 1961 (22 U.S.C. 2151b– 
2(e)) the President shall submit to the appropriate con-
gressional committees and make available to the public a 
report on the implementation of this Act for the prior fis-
cal year. The report shall include the following informa-
tion: 
(1) The results of the monitoring and evalua-
tion system required under subsection (e). 
(2) A description of the prevention programs 
designed to address the vulnerabilities to HIV/AIDS 
of married and unmarried women and girls. 
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(3) A list of all nongovernmental organizations 
in each country that receive assistance from the 
United States to carry out HIV prevention activities, 
including the amount and the source of funding re-
ceived. 
SEC. 4. BALANCING FUNDING FOR HIV PREVENTION METH-
ODS. 
(a) FINDINGS.—Congress finds the following: 
(1) While effective evidence-based and measur-
able strategies for delaying sexual debut are critical 
components of comprehensive HIV prevention pro-
grams, current United States funded HIV preven-
tion programs based on the ABC model of ‘‘Abstain, 
Be faithful, use Condoms’’ are too narrow in scope 
and do not respond to the specific vulnerabilities of 
women and girls. 
(2) In order to maximize the impact of United 
States foreign assistance to combat HIV/AIDS, all 
sexually active persons in each country must be 
equipped with all the skills and tools necessary to 
avoid infection, including information and training 
on delay of sexual debut and the practice of safer 
sex, whether sexual activity begins within or outside 
of marriage. 
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(3) Under section 403(a) of the United States 
Leadership Against HIV/AIDS, Tuberculosis, and 
Malaria Act of 2003 (Public Law 108–25; 22 U.S.C. 
7673), 33 percent of all United States foreign assist-
ance provided for preventing the spread of HIV 
must be spent on abstinence-until-marriage pro-
grams. Based on operational guidance to field mis-
sions of the United States Government, in order to 
meet this requirement, 50 percent of all United 
States foreign assistance provided for preventing the 
spread of HIV at the country level must be spent on 
prevention of sexual transmission and 66 percent of 
all such funding for sexual transmission must be 
spent on the Abstinence and Be faithful components 
of the ABC model. 
(4) A recent report by the Government Ac-
countability Office (Global Health: Spending Re-
quirement Presents Challenges for Allocating Pre-
vention Funding under the President’s Emergency 
Plan for AIDS Relief, GAO–06–395, April 4, 2006) 
found the following: 
(A) Because it requires country teams to 
segregate the Abstinence and Be faithful com-
ponents of the ABC model from funding for 
‘‘other prevention’’, the abstinence-until-mar-
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