I 
109TH CONGRESS 
2D SESSION 
H. R. 5674 
To require the President and the Office of the Global AIDS Coordinator 
to establish a comprehensive and integrated HIV prevention strategy 
to address the vulnerabilities of women and girls in countries for which 
the United States provides assistance to combat HIV/AIDS, and for 
other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
JUNE 22, 2006 
Ms. LEE (for herself, Mr. LEACH, Mr. LANTOS, Mrs. MALONEY, Ms. CORRINE 
BROWN of Florida, Ms. JACKSON-LEE of Texas, Mr. JEFFERSON, Mr. 
PAYNE, Mr. GUTIERREZ, Ms. NORTON, Mr. HONDA, Ms. SCHAKOWSKY, 
Mr. MCDERMOTT, Mr. CONYERS, Mr. WAXMAN, Mr. BERMAN, Ms. 
WOOLSEY, Ms. WATERS, Mr. MCGOVERN, Mr. CROWLEY, Mr. BROWN of 
Ohio, Mrs. MCCARTHY, Mr. WEXLER, Mrs. CHRISTENSEN, Mr. MEEKS 
of New York, Ms. MCCOLLUM of Minnesota, Mr. CAPUANO, Mr. SHAYS, 
Mr. PALLONE, Mrs. CAPPS, Mr. BLUMENAUER, Ms. MCKINNEY, Mr. 
OWENS, Mr. CUMMINGS, Mr. CARNAHAN, Mr. WYNN, Ms. SOLIS, Mr. 
NADLER, Mr. DAVIS of Illinois, Mr. STARK, Mr. FRANK of Massachu-
setts, Mr. MORAN of Virginia, Mr. SCOTT of Virginia, Mr. CLYBURN, Mr. 
DELAHUNT, Ms. KILPATRICK of Michigan, Mr. SANDERS, Ms. WATSON, 
Mr. RUSH, Mr. KUCINICH, Mr. GRIJALVA, Mr. LEWIS of Georgia, Mrs. 
TAUSCHER, Mr. JACKSON of Illinois, Mr. BISHOP of Georgia, Ms. CAR-
SON, and Ms. HARMAN) introduced the following bill; which was referred 
to the Committee on International Relations 
A BILL 
To require the President and the Office of the Global AIDS 
Coordinator to establish a comprehensive and integrated 
HIV prevention strategy to address the vulnerabilities 
of women and girls in countries for which the United 
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States provides assistance to combat HIV/AIDS, and 
for other purposes. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Protection Against 
Transmission of HIV for Women and Youth Act of 2006’’. 
SEC. 2. FINDINGS. 
Congress finds the following: 
(1) Globally, the United Nations Joint Program 
on AIDS (UNAIDS) estimates that at the end of 
2005 there were more than 38,600,000 people in-
fected with HIV/AIDS, the vast majority of whom 
are living in the developing world. 
(2) According to the World Health Organiza-
tion (WHO) unprotected heterosexual sex is now the 
single most important factor in the spread of HIV 
infections worldwide, representing 80 percent of new 
infections in sub-Saharan Africa. 
(3) According to UNAIDS, women and adoles-
cent girls account for about half of all HIV infec-
tions worldwide. In sub-Saharan Africa, women and 
girls make up 60 percent of all infections and 76 
percent of infections among those ages 15–24. 
(4) Women and girls are biologically, socially, 
and economically more vulnerable to HIV infection. 
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Gender disparities in the rate of HIV infection are 
the result of a number of factors, including the fol-
lowing: 
(A) Cross generational sex with older men 
who are more likely to be infected with HIV, 
and a lack of choice regarding when and whom 
to marry, leading to early marriages and high 
rates of child marriages with older men. About 
half of all adolescent females in Africa and two- 
thirds of adolescent in Asia are married by age 
18. 
(B) High rates of infection within mar-
riage. Research shows that married girls are 
more likely to have unprotected sex and have 
far more frequent sex than their unmarried 
peers, indicating that marriage cannot be con-
sidered a protective factor against HIV infec-
tion. 
(C) An inability to negotiate safe sex in 
marriage or with regular partners. Studies show 
that married women and married and unmar-
ried adolescent females often are unable to ne-
gotiate the frequency and timing of sexual 
intercourse, ensure their partner’s faithfulness, 
or insist on condom use. Women often run the 
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risk of being infected by husbands or male part-
ners in societies where it is common or accepted 
for men to have more than one partner. 
(D) Social and economic inequalities based 
largely on gender which limit access for women 
and girls to education and employment opportu-
nities and which prevent them from asserting 
their inheritance and property rights. For many 
women, a lack of independent economic means 
sustains their fear of abandonment, eviction, or 
ostracism from their homes and communities, 
and can leave many more of them trapped with-
in relationships where they are vulnerable to 
HIV infection. 
(E) A lack of educational opportunities for 
women and girls which are linked to delayed 
intercourse, increased age-at-marriage, delayed 
childbearing, increased child survival, improved 
nutrition, and reduced risk of HIV infection, 
among other positive outcomes. 
(F) High rates of gender-based violence, 
rape, and sexual coercion within and outside of 
marriage. According to the WHO, between one- 
sixth and three-quarters of women in various 
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countries and settings have experienced some 
form of physical or sexual violence since age 15. 
(G) Fear of domestic violence and the con-
tinuing stigma and discrimination associated 
with HIV/AIDS prevents many women from ac-
cessing information about HIV/AIDS, getting 
tested, disclosing their HIV status, accessing 
services 
to 
prevent 
mother-to-child 
trans-
mission, or receiving treatment and counseling 
even when they already know they have been in-
fected with HIV. 
(H) An increase in commercial sex for sur-
vival, due to pervasive poverty, social disloca-
tion, war and internal conflicts, and other fac-
tors. According to UNAIDS, the vulnerability 
of sex workers to HIV infection is heightened 
by stigmatization and marginalization, limited 
economic options, limited access to health, so-
cial, and legal services, limited access to infor-
mation and prevention means, gender-related 
differences and inequalities, sexual exploitation 
and trafficking, harmful or nonprotective legis-
lation and policies, and exposure to risks associ-
ated with commercial sex such as violence, sub-
stance use, and increased mobility. 
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